Child Psychology and Psychiatry

Early-onset bipolar disorder
Stage 2
Alternate mood stabiliser & atypical antipsychotic
Stage 3
Combination of two mood stabilisers & atypical antipsychotic
Stage 4
ECT (adolescents)
Clozapine
or
Stage 1
Monotherapy with mood stabilizer
and
atypical antipsychotic
∗
∗
Mood stabilizers – lithium; sodium valproate; carbamazepine
∗
Atypical antipsychotics – olanzapine; quetiapine; risperidone;
aripirazole
Figure 33.2
Bipolar disorder type I (BPD-I), manic, mixed, with psychosis. ECT, electroconvulsive
therapy.
individual components for bipolar disorder [33],
which may be a promising treatment.
Overall, there are clear limitations to present
treatments, with one study finding that participa-
tion in community treatment (including mood sta-
bilizers) did not improve outcome at 2 years [20].