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There are no studies of treatment of children with PC, therefore the following guidelines are anecdotal. Clinically, it is important to differentiate the subtypes because treatment approaches are different. The affective instability and aggressive types co-occur frequently (Max et al. 2001) and respond similarly to treatment. Mood-stabilizing medications such as carbamazepine and valproic acid can be particularly effective when combined with a behavior modification program targeting aggression. Adding a selective serotonin reuptake inhibitor (SSRI) to a mood stabilizer may be helpful as well. This may be counterintuitive for clinicians who work with children because of the well-known side effects of irritability and restlessness with SSRIs. Adults with affective instability (e.g., pathological laughter and pathological crying) have responded well to SSRIs (Robinson et al. 1993).

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