Bipolar Disorder Treatment: Medications

Bipolar Disorder Treatment Medications

Medications for Bipolar Disorder

Mood stabilizers such as lithium and anticonvulsants are the main medications for bipolar disorder. Often medications are combined for best effect.

Bipolar disorder (sometimes called manic-depressive illness) may be treated with several different types of medications. For most people with bipolar, medicine is the only way to control symptoms so they can enjoy a normal life.

Bipolar disorder is marked by mood changes that cycle between severe highs (mania) and lows (depression). Cycles may be mostly mania or depression with normal mood between cycles. Without treatment, episodes usually last from several days to several weeks.

Mood stabilizers (such as lithium), anticonvulsants, and antipsychotics are the main medications for bipolar disorder. Benzodiazepines and antidepressants are sometimes used as well. Often medications are combined to get the best effect. It may take some time to find the right drug or combination of drugs to manage bipolar effectively.

Mood stabilizers

Lithium

Generic/brand name examples: Lithium carbonate (Eskalith, Lithane, Lithobid, Lithonate, Lithotabs)

Anticonvulsants

Generic/brand name examples:

  • Valproic acid or divalproex (Depakote, Depakene)
  • Carbamazepine (Tegretol, Equetro)
  • Lamotrigine (Lamictil)
  • Oxcarbazepine (Trileptal)

Lithium and anticonvulsant medications are called mood stabilizers because they help level out mood in people with bipolar disorder.

Lithium is the most common medication used to control manic episodes. It can reduce severe manic symptoms in about one to two weeks. Often it is used long-term to help prevent manic episodes and keep mood more stable.

An episode of mania is usually preceded or followed by depression. Lithium can even out mood swings in both directions. It may be used along with an antidepressant during a depressive episode.

Anticonvulsant mood stabilizers were first developed to control seizures, but they are also very good at controlling mood. For some people, they work better than lithium.

Valproic acid can be very effective for mixed mania and rapid cycling. Carbamazepine may be prescribed to treat mania or mixed mania and depression. Lamotrigine may be used along with other medications to delay episodes of depression and mania.

Atypical antipsychotics

Generic/brand name examples:

  • Risperidone (Risperdal)
  • Quetiapine (Seroquel)
  • Aripiprazole (Abilify)
  • Olanzapine (Zyprexa)

Atypical antipsychotics are often prescribed along with mood stabilizers to treat bipolar disorder. They can be used to treat manic episodes, and they may be useful if you have had hallucinations or delusions. An antipsychotic may be tried if mood stabilizers have not worked.

Antidepressants

Generic/brand name examples:

  • Fluoxetine (Prozac)
  • Sertraline (Zoloft)
  • Paroxetine (Paxil)

Antidepressants are sometimes prescribed to treat bipolar disorder. However, a mood stabilizer is the preferred treatment for depressive episodes. Antidepressants do not seem to work as well for bipolar depression, plus they raise the risk of a manic episode. For this reason they are used with caution if at all.

Benzodiazepines

Generic/brand name examples:

  • Clonazepam (Klonopin)
  • Lorazepam (Ativan)
  • Alprazolam (Xanax)
  • Diazepam (Valium)

It may take a few weeks for a mood stabilizer to become effective. In the interim, a benzodiazepine may be prescribed to relieve symptoms of mania. Benzodiazepines are central nervous system depressants, or sedatives. They can help slow down brain function and aid sleep.

Benzodiazepines are highly addictive, so they are only used short-term.

General concerns about bipolar medications

  • Side effects. Bipolar medications can cause side effects, but they may go away as your body adjusts to the medication. Be sure you know what side effects to watch for, and call your doctor if you have any side effects that are severe, unusual, or don’t go away. It may be possible to adjust the dose or switch medications.
  • Blood tests. You may need regular blood tests while taking bipolar medications. These are very important to help protect your health. Make sure you get all the tests and checkups your doctor suggests.
  • Pregnancy. Some bipolar medications raise the risk of birth defects or should not be taken while breast-feeding. Talk to your doctor about these risks before you get pregnant or start breast-feeding.
  • Drug interactions. Serious or dangerous side effects can occur if bipolar medications are taken with many other medications, including some over-the-counter drugs. Always check with your doctor before you take any new medication, herb, vitamin, or supplement.

Do not stop taking any medication on your own, without first talking with your doctor.

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