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January 5, 2012

Bipolar Treatment: Medications

Mood-stabilizing medications are a common treatment for bipolar disorder, often coupled with other drugs and psychotherapy. But what exactly are these medications, and how do they help? Mood-stabilizers form the foundation of bipolar drug therapy, and help treat and prevent the manic highs and depressive lows of the illness. The most widely studied and commonly used mood-stabilizer is Lithium, typically the first drug prescribed for treating bipolar disorder. Studies suggest Lithium may be up to 80 percent effective in reducing the episode frequency of mania and hypomania. The drug also helps psychosocial functioning, and research suggests it may provide up to a six-fold reduction in suicide risk. But Lithium may not be effective for everyone. Blood levels must be monitored regularly to protect against toxic levels of the drug. A number of other drugs are used to treat bipolar disorder, including anticonvulsants, antipsychotics, benzodiazepines and antidepressants. Anticonvulsant drugs are believed to affect the neurotransmitter gamma aminobutyric acid by preventing the over-firing of nerve cells. They may stabilize mood and reduce manic symptoms, and are considered a good option for people who can't tolerate Lithium. The anticonvulsant Valporic acid, known also as Depakote, Divalproex, or Valproate, is considered to be highly effective in treating rapid cycling, mixed mania, and mania with delusions or hallucinations. Other anticonvulsants that may be used to stabilize mood include Carbamazepine, branded as Tegretol and Lamotrigine, known also as Lamictal, which may be helpful in patients where depression is problematic. A doctor may prescribe antipsychotic medications if patients lose touch with reality or when mood stabilizers aren't effective. Common antipsychotics include: Olanzapine, or Zyprexa, Quetiapine, better known as Seroquel, Risperidone, or Risperdal, Ariprazole, or Abilify, Ziprasidone, or Geodon, and Clozapine, known also as Clozaril. Antidepressants may be used to treat bipolar depression, and are typically grouped according to the brain chemical each affects, such as Selective Serotonin Reuptake Inhibitors or Monoamine Oxidase Inhibitors. Antidepressants should be used with caution, however, as they can trigger mania and have a mood destabilizing effect over time. For that reason, they're typically prescribed along with mood stabilizers. Since mood stabilizers and antidepressants may take several weeks to work effectively, fast-acting sedatives called benzodiazepines may be prescribed as an interim treatment to relieve anxiety, agitation or insomnia. Common Benzodiazepines include Klonopin, the brand name of Clonazepam, Ativan, or Lorazepam, Xanax, or Alprazolam, and Valium, generically prescribed as diazepam. However, benzodiazepines should be used sparingly as they're all habit-forming. Bipolar medications may cause various side effects depending on the type prescribed. It's important to work with your mental health professional to determine the right medication for you. Stopping your medication without consulting your doctor may be dangerous. Talk with your mental health provider about your medications and any side effects you may experience. To learn more, watch the video series on bipolar disorder on this site.


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Last Updated:
December 20, 2012