Bipolar disorder (BD) frequently occurs in children and adolescents, but pharmacological treatment in this group presents significant challenges. Clinicians often struggle to find appropriate treatment guidelines due to the primary focus of current guidelines on adults, leaving specific recommendations for the acute and maintenance treatment of BD in children and adolescents either insufficient or entirely absent. This gap is partly due to the lack of targeted studies in this age group, leading practitioners to rely on clinical experience and studies conducted in adults. I describe a case of the treatment of a 14-year-old girl with BD type 1, who received both psychotherapy and psychopharmacotherapy. The combination of aripiprazole, olanzapine, and lithium proved effective for this patient, but formal evidence for this regimen is lacking in the guidelines. This underscores the need for further research and the development of updated guidelines for the pharmacological treatment of BPSS in children and adolescents.