Bipolar I Disorder in Children and Adolescents Sample Paper

Bipolar I Disorder in Children and Adolescents Sample Paper

The prevalence of Bipolar I disorder among children and adolescents is about 1 in 200 globally, with no significant difference in U.S. population rates compared to other countries (Findling et al., 2018). The disease causes high impairment rates among the affected children and adolescents. Bipolar I disorder is a mental illness characterized by manic behavior and severe depression. Treatment of bipolar involves both pharmacological and non-pharmacological methods. In children and adolescents, treatment and management of the condition requires several considerations as explored in this paper.

The FDA’s recommended pharmacologic method for managing bipolar I disorder in children and adolescents is the olanzapine fluoxetine combo. This drug belongs to the group of atypical antipsychotics. This medication is the first-line choice by the FDA in managing symptoms of acute mania and mixed episodes of bipolar I disorder experienced by children and adolescents (Findling et al., 2018). Moreover, this medication is proven to help in the prevention of the reoccurrence of bipolar I disorder.

An off-label medication that is used in managing Bipolar I disorder is the use of Olanzapine. This drug belongs to a second-generation antipsychotic agent. A lot of trials have been conducted to prove the efficacy of Olanzapine in managing bipolar one disorder, and the results show that Olanzapine (Zyprexa) is a viable option in managing bipolar I disorder (O’Brien & Mark, 2017). Despite these trials showing that this medication is optional for Bipolar I, many controversies have emerged about its safety and tolerability in managing Bipolar I in children and adolescents. Therefore, more research needs to be done to provide more knowledge about the use of this medication.

A non-pharmacologic intervention used in managing Bipolar I disorder is the use of cognitive and behavioral therapy. According to Lynch et al. (2021), this is psychotherapy whereby negative aspects of thoughts and a patient’s views of events surrounding them are challenged and altered to influence mania and mixed episodes’ behavior patterns. This method helps children recognize their negative thoughts and feelings, thus developing skills to combat these detrimental behaviors.

When selecting the best treatment intervention, the best risk assessment method is the fundamental clinical approach to risk management. In this, the nature of the presenting disorder, the current form of the disease is scrutinized before deciding which intervention to use (Findling et al., 2017). More information from family and friends regarding the patient’s condition is also gathered before deciding which intervention to take.

Recently, there has been an allegation that FDA drugs are not safe due to insufficient regulations and a lack of systems that ensures the safety of medications in the market, thereby risking the release of counterfeit medicines. However, FDA medications are proven to be most effective and safe compared to off-label, whose efficacy and side effects have not been established. Although research that demonstrates the safety of off-label medicines is not available, these medications are proven to effectively manage conditions whereby all the available treatment options fail to work.

Clinical practice guidelines for managing bipolar I in adolescents and children are available. The available guideline indicates that bipolar I disorder in children aged above ten years is managed using combined Olanzapine and fluoxetine (Shah & Rao, 2017). Moreover, the guideline recommends psychotherapy as one of the most effective methods of managing Bipolar I disorder.

Bipolar I disorder is one of the severe mental disorders affecting children and adolescents. Although the disease rarely occurs in children, the condition is more detrimental when it develops. The choice of treatment of treatment for the condition remain limited compared to bipolar II disorder. For this reason, FDA needs to conduct more research to determine other medications for managing bipolar I in children and adolescents.


  • Findling, R. L., Stepanova, E., Youngstrom, E. A., & Young, A. S. (2018). Progress in diagnosis and treatment of bipolar disorder among children and adolescents: an international perspective. Evidence Based Mental Health, 21(4), ebmental-2018-102912–. doi:10.1136/eb-2018-102912
  • O’Brien, P. L., Cummings, N., & Mark, T. L. (2017). Off-label prescribing of psychotropic medication, 2005–2013: an examination of potential influences. Psychiatric Services, 68(6), 549-558.
  • Shah, N., Grover, S., & Rao, G. P. (2017). Clinical practice guidelines for the management of the bipolar disorder. Indian Journal of Psychiatry, 59(Suppl 1), S51.
  • Lynch, F. L., Dickerson, J. F., Rozenman, M. S., Gonzalez, A., Schwartz, K. T., Porta, G., … & Weersing, V. R. (2021). Cost-effectiveness of Brief Behavioral Therapy for Pediatric Anxiety and Depression in Primary Care. JAMA Network Open, 4(3), e211778-e211778. doi:10.1001/jamanetworkopen.2021.1778