In the news: Advancing Pediatric Bipolar Disorder Treatment: The Critical Role of Lithium
Adelaide Robb, MD, is the chief of Psychiatry and Behavioral Sciences at Children’s National Hospital and a leading expert in the treatment and research of pediatric bipolar disorder. As a psychopharmacologist, Dr. Robb frequently prescribes lithium to treat bipolar mania in children and adolescents. While she acknowledges that lithium requires a more nuanced approach compared to faster-acting anti-psychotics, its proven effectiveness — particularly in reducing suicide risk — makes it one of the most reliable treatments, as supported by federally funded trials.
“My philosophy is that everyone with bipolar disorder deserves a lithium trial,” says Dr. Robb. When discussing the use of lithium, it is vital that patients and families understand the nature of bipolar disorder and the importance of early intervention. Dr. Robb highlights that the onset of bipolar symptoms typically occurs 3-5 years before the development of comorbid substance use disorders, creating a critical window of opportunity. By managing bipolar symptoms early, we can potentially prevent self-medication through substance use.
“We know that lithium is effective for children 7 and up, and we know it reduces the risk of death by suicide,” she explains. “When death by suicide is our worst outcome, any opportunity we have to reduce that risk — or prevent it altogether — is an important choice to make.”
Dr. Robb recently appeared on the Neuroscience Education Institute (NEI) Podcast, where she joined Jeffery R. Strawn, MD, to discuss the key aspects of lithium treatment. The topics covered included the importance of carefully calibrated dosing, proactive side effect management, and the essential role of parental involvement in treatment decisions. Learn more about her thoughts on the NEI Podcast.
