Mood stabilizers are typically considered the best medication for bipolar disorder. Learn about other medications and treatment options
Mood stabilizers are typically considered the best medication for bipolar disorder.
However, treatment of bipolar disorder should be individually tailored to your symptoms, frequency of mood swings, and response to treatment. In addition to mood stabilizers, doctors may also prescribe atypical antipsychotics and antidepressants.
- Mood stabilizers
- First line of treatment for most people with bipolar disorder, used to control both mania and depression
- Common examples are Lithobid (lithium) and Depakote (valproic acid) although quetiapine has also shown good efficacy is quetiapine
- Atypical antipsychotics
- May be added to the treatment regimen if mood stabilizers do not relieve your symptoms or if you have hallucinations
- Common examples include Zyprexa (olanzapine) and Abilify (aripiprazole)
- Antidepressants
- May be added to the treatment regimen to get depression under control
- Common examples include Wellbutrin (bupropion) or Paxil (paroxetine)
- Should be taken along with a mood stabilizer to prevent triggering manic symptoms
- Other medications
- Symbyax (fluoxetine + olanzapine) works to treat depression
- Some may include benzodiazepines to help reduce anxiety and improve sleep
What are potential side effects of bipolar medications?
Common side effects of these drugs may include:
- Hair loss
- Indigestion
- Tremors
- Weakness
- Constipation
- Dizziness
- Drowsiness
- Headache
- Weight changes
- Dry mouth
- Nausea
- Sexual problems
It’s imperative to work with your doctor or psychiatrist to manage your drug therapy. Because bipolar disorder symptoms vary greatly from person to person, it can take time to identify the best medication to manage your symptoms. Sometimes, you may need to try a few medications or combinations of medications before finding the right one.
What therapies are used to treat bipolar disorder?
The most effective treatment of bipolar disorder combines medication and psychotherapy. Therapies that stimulate the brain and combine lifestyle changes may also be beneficial.
- Psychotherapy: Researchers found that people who used bipolar-specific psychotherapy with medication had better results than those who did not.
- Cognitive behavioral therapy (CBT): This treatment helps people recognize and modify the way they think and act to reduce episodes of mania and depression. Studies have shown that CBT increases the length of time between mood episodes.
- Family-focused therapy (FFT): This treatment focuses on training people on how to better communicate and help in problem-solving techniques. Researchers found that FFT sped up recovery and helped protect people against recurrence.
- Interpersonal and social rhythm therapy (IPSRT): This treatment helps people interact with others and schedule their daily activities in a better way. The theory is that having a routine will help regulate biological rhythms and reduce mood episodes. Researchers found that this type of therapy is effective to control acute episodes and as a maintenance treatment.
- Electroconvulsive therapy (ECT) and deep brain stimulation (DBS): These treatments use electric currents to stimulate the brain and treat symptoms of bipolar disorder. Although these treatments have shown some promise, most are still experimental.
- ECT can be effective in treating manic and depressive episodes in people who do not respond to medication and psychotherapy. It is administered under anesthesia and may be helpful to prevent suicide.
- Side effects of ECT include headache, muscle pain, memory loss, and confusion. Side effects of DBS include speech problems, mood swings, brain bleeding, insomnia, and breathing problems.
What are symptoms of bipolar disorder?
Bipolar disorder (manic-depressive illness) is a neurobiological brain disorder that affects almost 1% of the population. Individuals diagnosed with this disease have mood swings that alternate from periods of severe highs (mania) to extreme lows (depression). Suicide is the number one cause of premature deaths among people with bipolar disorder, with 15%-17% of people taking their own lives because of negative symptoms that come from untreated illness. Other symptoms depend on mood swings.
During a manic high, people may feel:
- Very happy, energetic or on edge
- Like they need very little sleep
- Overly self-confident
- Like spending a lot of money or getting involved in dangerous activities
After a manic episode, they may return to normal and then experience a mood swing in the opposite direction to a depressive episode. During a depressive low, people may have:
- Trouble thinking and making decisions
- Memory problems
- Less interest in things they enjoyed in the past
- Thoughts about killing themselves
There’s no secret formula to managing bipolar disorder, but there are many treatment paths depending on your goals.