A paper published in the April 1976 issue of the Journal of Diseases in Childhood described five cases of childhood mania. All the children described came from obviously troubled families. In three of the five cases the authors explicitly state that the mania did not develop until after the children had begun taking stimulants or antidepressants.
The five case histories give us poignant glimpses into the lives of these children. A fifteen-month-old toddler, born to a mother with a history of episodic depression, became jealous of her baby sister, and would hit the baby and steal her bottle. The paper doesn't mention whether the child (or her mother) was offered any kind of therapy or counseling to help deal with the flood of feelings that must inevitably accompany the arrival of a new family member. Instead, the toddler was treated first with diphenhydramine, then dextroamphetamine, then nortriptyline, then phenobarbital. After the phenobarbital was discontinued, the child was kept on nortriptyline, at which point she experienced her first episode of full-blown mania, characterized by unintelligible speech, insomnia, hyperactivity, irritability, and delusional fantasies (pretending to be an airplane, she crashed into a wall and sustained two scalp lacerations). She was switched to Elavil, which made her condition worse, and then to thioridazine. Finally the mother discontinued all the drugs, and within a month the child's behavior became normal and remained that way at the time of follow-up at five years.
