Abstract
Introduction There is a resurgence of interest in lithium treatment of bipolar disorders in part
related to its unique anti-suicidal and neuroprotective effects.
Methods This is a narrative review of key studies pertaining to the effectiveness and tolerability
of lithium treatment in pediatric populations.
Results Evidence supports that lithium is an effective and generally well-tolerated acute
treatment for pediatric mania compared to placebo. Lithium may be less effective than
risperidone for treating chronic mixed/manic symptoms in young children but comparable
to anticonvulsants. However, in comparison, risperidone was associated with higher
weight gain and prolactin levels. There is a lack of evidence inform maintenance treatment
in children who benefit from lithium. Other indications that require further study
include treatment of refractory or recurrent major depression in children at confirmed
familial risk of bipolar disorder, as well as the treatment of acute suicidal ideation/behavior
and refractory aggression.
Discussion There is inadequate data about the full variety of benefit and tolerability of lithium
treatment in pediatric patients. However, given the potential for protection against
suicide and neurotoxic effects of illness, further studies should be a priority.
Key words
lithium treatment - children and adolescents - narrative review
