Primary care pediatricians may find themselves treating mood disorders in children with whom they have an established relationship. In almost all cases, consultation with a child behavioral specialist will be indicated. Child psychologists may be involved to diagnose and counsel families. Children with mood disorders require frequent follow-up and multidisciplinary care, including counseling, educational interventions (diagnostic and appropriate therapies and classroom adaptations) and pharmacotherapy.
Valproex, carbamazepine or oxcarbamazepine are anticonvulsants which are useful for some children who have unpredictable mood swings not responsive to stimulants or antidepressants, and divalproex may be a better choice for managing angry, impulsive behavior.
Other pharmacologic options for mood stabilization include risperidone, olanzapine and other atypical antipsychotic agents that appear to have an improved side-effect profile when compared to traditional antipsychotics.