Its high risk for weight gain and metabolic complications make it a second-line choice for kids and adolescents. Consider co-administering metformin to prevent weight gain.

Here are some hard-won tips and pearls that you might find useful in your practice.

Lower risk for EPS and a broad spectrum of efficacy make this an appealing first-choice agent. However, sedation, weight gain, and orthostasis may limit use. 

Although clinicians often try other medications first due to both the relative complexity of managing lithium as well as bias from the public, lithium, along with several second-generation antipsychotics, is FDA indicated and considered first line for treating pediatric bipolar disorder.

Not for first-line use for most kids due to limited data (open-label studies only), long titration required, and increased relative risk of rash in pediatric population.

Not a first-line treatment for bipolar disorder in kids due to limited data, side effect profile, and high likelihood of significant interactions.

Risperidone offers more efficacy and safety data in kids than other antipsychotics and is often used first-line in autistic kids, but you need to expect and monitor for EPS, prolactinemia, and weight gain.

Compared to carbamazepine, oxcarbazepine poses less concern for drug interactions and for hepatic or hematologic toxicities; it also does not require serum level monitoring.

Very high expense and unpleasant side effects make this form of nicotine replacement therapy difficult to recommend as a first-line option since no single therapy has been shown to be more effective than another. 

First-line intervention for those patients who can stop smoking at initiation of therapy; nicotine in the form of gum or lozenge may act as a substitute oral activity, which may aid in behavior modification.