Mood stabilizers have not been well studied in the treatment of children and adolescents. Moreover, adequate research has not been conducted regarding combinations of mood stabilizers in children with bipolar disorder. Much of what we know about anticonvulsants in this population is based on studies of epilepsy. In addition to the increased risk of rashes with lamotrigine, other mood stabilizers may pose distinct risks in the pediatric population. For instance, valproic acid may cause a higher risk of liver failure (4) and thrombocytopenia (5) in children. Also, gabapentin has been reported to cause behavioral side effects (6, 7) Carbamazepine has been reported to be well tolerated in children (8), but cases have been reported that suggest that it may unmask a Tourette’s-like syndrome (9). Lithium has been reported to be effective in the acute treatment of bipolar disorder in children (10) but has also been shown to cause frequent side effects, especially neurologic, including tremor, drowsiness, ataxia, and confusion (11).