What medications are used to treat bipolar disorder?

What medications are used to treat bipolar disorder?

Certain medications can help manage symptoms of bipolar disorder. You may need to try several different medications, with guidance from your healthcare provider, before finding what works best.

Medications healthcare providers generally prescribe to treat bipolar disorder include:

  • Mood stabilizers.
  • Second-generation (“atypical”) neuroleptics (also called antipsychotics).
  • Antidepressants.

If you’re taking medication for bipolar disorder, you should:

  • Talk with your healthcare provider to understand the risks, side effects and benefits of the medication.
  • Tell your healthcare provider about any prescription drugs, over-the-counter medications or supplements you’re already taking.
  • Tell your healthcare provider right away if you’re experiencing concerning side effects. They may need to change your dose or try a different medication.
  • Remember that medication for bipolar disorder must be taken consistently, as prescribed.

Mood stabilizers for bipolar disorder

People with bipolar disorder typically need mood-stabilizing medication to manage manic or hypomanic episodes.

Types of mood stabilizers and their brand names include:

  • Lithium (Eskalith®, Lithobid®, Lithonate®).
  • Valproic acid (Depakene®).
  • Divalproex sodium (Depakote®).
  • Carbamazepine (Tegretol®, Equetro®).
  • Lamotrigine (Lamictal®).

Lithium is one of the most widely prescribed and studied medications for treating bipolar disorder. Lithium is a natural salt and will reduce symptoms of mania within two weeks of starting therapy, but it may take weeks to months before the manic symptoms are fully managed. Because of this, healthcare providers often prescribe other drugs like antipsychotic drugs or antidepressant drugs to help manage symptoms.

Thyroid gland and kidney problems can sometimes develop when taking lithium, so your healthcare provider will monitor the function of your thyroid and kidneys, as well as monitor the levels of lithium in your blood, as levels can easily become too high.

Anything that lowers the level of sodium in your body, such as switching to a low-sodium diet, heavy sweating, fever, vomiting or diarrhea may cause a toxic buildup of lithium in your body. Be aware of these conditions and alert your doctor if you’re on lithium and experience them.

The following are signs of lithium toxicity (lithium overdose). Call your healthcare provider immediately or go to the nearest emergency room if you experience:

  • Blurred vision or double vision.
  • Irregular pulse.
  • Extremely fast or slow heartbeat.
  • Difficulty breathing.
  • Confusion and dizziness.
  • Severe trembling or convulsions.
  • Passing large amounts of pee.
  • Uncontrolled eye movements.
  • Unusual bruising or bleeding.

Neuroleptic medications for bipolar disorder

Healthcare providers often prescribe second-generation or atypical neuroleptics (antipsychotics) in combination with a mood stabilizer for people with bipolar disorder. These medications help with both manic and depressive episodes.

Only four of these drugs are U.S. Food and Drug Administration (FDA)-approved to help treat bipolar depression, including:

  • Cariprazine (Vraylar®).
  • Lurasidone (Latuda®).
  • Olanzapine-fluoxetine combination (Symbyax®).
  • Quetiapine (Seroquel®).

However, other medications, such as olanzapine (Zyprexa®), risperidone (Risperdal®) and aripiprazole (Abilify®), are commonly prescribed as well.

Antidepressants for bipolar disorder

Healthcare providers sometimes prescribe antidepressant medication to treat depressive episodes in bipolar disorder, combining the antidepressant with a mood stabilizer to prevent triggering a manic episode.

Antidepressants are never used as the only medication to treat bipolar disorder because only taking an antidepressant drug can trigger a manic episode.

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