Abstract
Bipolar disorder among children has gained acceptance as a diagnostic entity but continues to pose diagnostic and management challenges due to the developmental differences in children and inadequate evidence for pharmacological management. We present the case of a prepubertal child presenting with an apparent depressive episode who developed treatment-emergent mania when commenced on sertraline. This case highlights the need for further research into the presentations and pharmacological management of prepubertal children with bipolar affective disorder.