Treatment for bipolar disorder has come a long way in a short time. Not so long ago, patients were given sedatives and medications with numerous side effects. Today, mood-stabilizing drugs are a fundamental treatment for bipolar disorder. Doctors may prescribe lithium, an antimanic medication, an antipsychotic medication, or a combination of both to relieve symptoms of depression without triggering a manic episode.
When antidepressants are given alone to a person with bipolar disorder, there is a risk that the medication will trigger a manic episode in some patients. The best way to guide treatment is by a doctor who specializes in the diagnosis and treatment of mental health conditions (psychiatrist) who is trained in the treatment of bipolar disorders and related disorders. Tricyclic antidepressants, oral lamotrigine, oral carbamazepine, oral aripiprazole, quetiapine (Seroquel, Seroquel XR), olanzapine (Zyprexa) with fluoxetine (Prozac), and lurasidone (Latuda) are all medications that can be used to treat bipolar disorder. In the UK, lithium is the main medication used to treat bipolar disorder and is usually prescribed for at least 6 months.
If you are prescribed lithium, stick to the prescribed dose and do not stop taking it suddenly, unless directed to do so by your doctor. For lithium to be effective, the dosage must be correct. If it's not right, you can suffer side effects, such as diarrhea and getting sick. Tell your doctor immediately if you have side effects while taking lithium. You'll need to have regular blood tests at least every 3 months while you're taking lithium.
This is to make sure your lithium levels aren't too high or too low. Your kidney and thyroid function will also need to be checked every 2 to 3 months if your lithium dose is adjusted, and every 12 months in all other cases. While taking lithium, avoid the use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, unless prescribed by your family doctor. In the UK, lithium and the antipsychotic drug aripiprazole are currently the only drugs officially approved for use in adolescents with bipolar disorder. Antiseizure medications are often used to treat epilepsy, but they are also effective in treating bipolar disorder.
A single anticonvulsant medication can be used, or they can be used in combination with lithium when bipolar disorder does not respond to lithium on its own. Antipsychotic medications are sometimes prescribed to treat episodes of mania. Antipsychotic medications can be especially helpful if symptoms are severe or if behavior is altered. If your symptoms don't improve, you may also be offered lithium and valproate. You may be prescribed a combination of lithium and valproate if you experience rapid cycles, in which you change rapidly from high to low levels without a normal period in between.
If this doesn't help, you may be offered lithium alone or a combination of lithium, valproate, and lamotrigine. Mood stabilizers are medicines that help control the ups and downs of bipolar disorder. They are the cornerstone of treatment, both for mania and depression. Lithium is the oldest and most well-known mood stabilizer and is very effective in treating mania. However, it's not as effective for mixed episodes or fast-cycling forms of bipolar disorder.
It takes one to two weeks for lithium to reach full effect. If your family doctor or psychiatrist recommends that you stop taking the medication for bipolar disorder, the dose should be reduced gradually for at least 4 weeks and up to 3 months if you are taking an antipsychotic or lithium. Weight gain is a common side effect of many medications for bipolar disorder, so it's important to adopt healthy eating habits to manage your weight. According to the American Psychiatric Association (APA), lithium, lamotrigine, valproate, carbamazepine and most atypical antipsychotic drugs are approved by the FDA to treat one (or more) phases of bipolar disorder. Living with bipolar disorder can be challenging, and having a strong support system can make a difference in your perspective and motivation. However, the Royal College of Paediatrics and Child Health states that other medications for bipolar disorder may be prescribed for children if recommended by their doctor. In addition, ECT may benefit women who are pregnant and suffer from severe bipolar depression or mania. As with any medication, talk to your doctor about the risks and benefits of taking antidepressants for bipolar disorder. Be sure to talk to your pharmacist or doctor about the best time of day to take your medications for bipolar disorder.