This work examines the problem of clinical differentiation and therapeutic procedures used in children with ADHD comorbid with bipolar affective disorder. In addition to the diagnostic difficulties involved in the treatment of children and adolescents, special attention is also required as far as pharmacological treatment is concerned. It is linked, on the one hand, with the risk of worsening the symptoms of attention defi cit and hyperactivity and, on the other, with the possibility of inducing a manic or depressive episode as the first episode of BD. It is also essential for a good therapeutic effect to anticipate and correct the possible side effects, such as epileptic fits and ticks, as it is important to remember that both of these disorders may co-occur or symptoms of ADHD may precede the affective disorders. Therefore, this work focuses on the basic standards of treatment, based on data from the available literature, which should help the diagnosis and therapeutic decisions in the case of juvenile BD and ADHD patients.