Mood Stabilizer Options for Adolescents with Depression

First-Line Options

• The American Academy of Child and Adolescent Psychiatry recommends lithium as the first-line mood stabilizer for adolescents with depression, as it is FDA-approved for patients 12 years and older for both acute mania and maintenance therapy, with evidence supporting its efficacy in preventing both manic and depressive episodes 1, 2

Second-Line Options

• Valproate is commonly used in clinical practice for both acute mania and maintenance therapy, though not specifically FDA-approved for adolescents, and requires baseline liver function tests, complete blood count, and pregnancy tests with periodic monitoring every 3-6 months 2
• The combination of valproate plus quetiapine has shown better efficacy than valproate alone for adolescent mania 2

Monitoring and Safety

• For lithium, regular monitoring of blood levels, thyroid function, renal function, and calcium levels is required every 3-6 months 2
• For valproate, monitoring of liver function tests and complete blood counts is necessary, and for female patients, discussion of potential risks related to reproductive health is advised 2