Drugs to Treat Bipolar Disorder

By Cristiano Antonino On Apr 8, 2022

If you have bipolar disorder, you’ll need to be treated on an ongoing basis. In fact, you should be seeing a mental health professional regularly, even if you feel fine. Treatment usually includes a combination of medication and talk therapy

Psychiatrists typically recommend medications as initial treatment to control symptoms as quickly as possible.

Once symptoms are under control, you’ll receive maintenance treatment to reduce the risk of relapse.

Maintenance treatment also reduces the chance of minor shifts in mood developing into mania or depression.

Several types of medications are used to treat bipolar disorder

These include mood stabilizers, antidepressants, and drugs that relieve anxiety. Your doctor may prescribe one or a combination of medications for maximum effect.

Finding the right medication or combination of medications will take some trial and error.

You may need to change medications due to side effects.

It can take up to eight weeks to see the full effects of each medication.

Usually, only one medication is changed at a time.

This helps your doctor to better monitor and identify which one isn’t working.

The following types of medications are used to treat bipolar disorder

Lithium

Lithium (such as Lithobid) is a mood-stabilizing drug that’s been used since the 1970s.

It helps control symptoms of acute mania.

It’s also effective at preventing the recurrence of periods of mania and depression.

Common side effects include weight gain and digestive issues.

The drug can also affect your thyroid and kidneys. Periodic blood tests are needed to monitor thyroid and kidney health.

Lithium is a category D drug that should be avoided in pregnancy if possible.

However, in some instances the benefits may outweigh the potential risks.

Anticonvulsants

Anticonvulsants are mood stabilizers used to treat bipolar disorder.

They have been used since the mid-1990s. A

nticonvulsant drugs include:

divalproex sodium (Depakote)
lamotrigine (Lamictal)
valproic acid (Depakene)

Common side effects of anticonvulsants include weight gain, drowsiness, and an inability to sit still.

Anticonvulsants are also associated with increased risk of suicidal thoughts and behavior.

Valproic acid is known to cause birth defects.

Lamictal is known to cause a rash that can be dangerous.

Alert your doctor to any new rash that develops while on Lamictal.

Antipsychotics

Antipsychotic drugs are another treatment option. Some commonly prescribed antipsychotics include:

olanzapine (Zyprexa)
risperidone (Risperdal)
quetiapine (Seroquel)
lurasidone (Latuda)
aripiprazole (Abilify)
asenapine (Saphris)

Common side effects include weight gain, drowsiness, dry mouth, decreased libido, and blurred vision.

Antipsychotics may also affect memory and attention.

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They are also known to cause involuntary facial or body movements.

Antidepressants

These include serotonin-reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MAOIs), and tricyclics.

Antidepressants may be added to help manage depression in bipolar disorder, but they can sometimes trigger manic episodes.

To reduce the risk of causing a mixed or manic episode, they are often prescribed along with a mood stabilizer or antipsychotic.

As with any medication, discuss with your doctor the risks and benefits of taking antidepressants for bipolar disorder.

Here are some of the more commonly prescribed antidepressants:

SNRIs
desvenlafaxine (Pristiq)
duloxetine (Cymbalta, Yentreve)
venlafaxine (Effexor)
SSRIs
citalopram (Celexa)
escitalopram (Lexapro)
fluoxetine (Prozac, Prozac Weekly)
paroxetine (Paxil, Paxil CR, Pexeva)
sertraline (Zoloft)
Tricyclics
amitriptyline
desipramine (Norpramin)
imipramine (Tofranil, Tofranil-PM)
nortriptyline (Pamelor)
MAOIs
phenelzine (Nardil)
tranylcypromine (Parnate)

In general, MAOIs are rarely prescribed unless a patient has a poor response to SNRIs or SSRIs.

Common side effects include reduced sexual desire, sleep disturbance, increased appetite, dry mouth, gastrointestinal troubles, and menstrual problems.

When taking an MAOI, it’s important to avoid other medications, and foods like wine and cheese, which can cause a rare but dangerous condition known as serotonin syndrome.