The Challenges of Treating Youths With Bipolar Disorder. - Psychiatricanswers

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The Challenges of Treating Youths With Bipolar Disorder.

By Karen Dineen Wagner MD, PhD
Jun 02, 2010

With the great respect that I have for Dr. Karen Dineen Warner for been one of the first prominent psychiatrists to acknowledge the presence of mood disorders in children (among other reasons) I want to comment on the persistent request for studies to prove what it is obvious. I believe that academic interest in research and FDA quest to increase the cost of producing a new medication should take second row seats, when issues such as self-esteem, physical harm, legal charges and academic failures are at stake.

After observing so many patients in their 80s in a full-blown manic state, why do we need a study to learn that bipolar disorder is a life-long disease?

If lamotrigine and valproic acid have been used for more than 20 years for the treatment of seizures in children as young as two year-old, why do we have to be afraid of giving these medications to a five year-old?

How can we justify to be so afraid of given mood stabilizers to children affected by mood disorders when teachers are making psychiatric diagnoses and pediatricians are accepting those "diagnoses" to dispense medications that are equivalents to street drugs such as cocaine and "speed"? 1

Should the American Academy of Child & Adolescent Psychiatry take a firm position to confront some of its members who insist in diagnosing ADHD in a child with Mental Retardation or Autism?

Would not be a better use of time and money to explain those professors of psychiatry that it is imperative to make clear to the new C&A psychiatrists that a child with low IQ cannot pay attention because of his or her cognitive deficit and that an autistic child does not devote attention to anything?  By the way, DSM-IV-TR clearly states that ADHD should not be Dx in these circumstances.

Children with mood disorders, OCD, Asperger disorder, low IQ (at times of parents with bipolar disorder) are been Rx every day with medication that make them more aggressive and hence, disliked by peers, failed by teachers, arrested by the police and sometimes, killed in a preventable accident. These scenarios, to me, should be priority.

Manuel Mota-Castillo, M.D.
Lake Mary, Florida

  1. Dr. Nora Volkow, multiple studies.

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