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There
are a variety of different drugs that can be prescribed for
people experience the symptom logy associated with bipolar disorder.
These medications are usually prescribed by a psychiatrist who
is an M.D. with expertise in mental disorder treatment.
These medications are known as "mood stabilizers"
and are usually prescribed to control bipolar disorder. There
are several different types of mood stabilizers available. Usually,
people with bipolar disorder continuously use mood stabilizers
over the entire period of their life. Other medications are
sometimes added in order to treat episodes of mania or depression
that may occur despite the mood stabilizers the individual is
utilizing.
There are a list of different drugs that can be administered
in order to control the Lithium, the first mood-stabilizing
medication approved by the U.S. Food and Drug Administration
(FDA) for treatment of mania, is often very effective in controlling
mania and preventing the recurrence of both manic and depressive
episodes. Children and adolescents with bipolar disorder generally
are treated with lithium,Anticonvulsant medications, such as
valproate (Depakote®) or carbamazepine (Tegretol®),
also can have mood-stabilizing effects and may be especially
useful for difficult-to-treat bipolar episodes.
Valproate was FDA-approved in 1995 for treatment of mania. Newer
anticonvulsant medications, including lamotrigine (Lamictal®),
gabapentin (Neurontin®), and topiramate (Topamax®),
are being studied to determine how well they work in stabilizing
mood cycles. Anticonvulsant medications may be combined with
lithium, or with each other, for maximum effect. Valproate and
carbamazepine also are used. Researchers are evaluating the
safety and efficacy of these and other psychotropic medications
in children and adolescents. There is some evidence that valproate
may lead to adverse hormone changes in teenage girls and polycystic
ovary syndrome in women who began taking the medication before
age 20. Therefore, young female patients taking valproate should
be monitored carefully by a physician.
Women with bipolar disorder who wish to conceive, or who become
pregnant, face special challenges due to the possible harmful
effects of existing mood stabilizing medications on the developing
fetus and the nursing infant. Therefore, the benefits and risks
of all available treatment options should be discussed with
a clinician skilled in this area. New treatments with reduced
risks during pregnancy and lactation are under study.
Research has shown that people with bipolar disorder are at
risk of switching into mania or hypomania, or of developing
rapid cycling, during treatment with antidepressant medication.16
Therefore, "mood-stabilizing" medications generally
are required, alone or in combination with antidepressants,
to protect people with bipolar disorder from this switch. Lithium
and valproate are the most commonly used mood-stabilizing drugs
today. However, research studies continue to evaluate the potential
mood-stabilizing effects of newer medications.
Atypical antipsychotic medications, including clozapine (Clozaril®),
olanzapine (Zyprexa®), risperidone (Risperdal®), quetiapine
(Seroquel®), and ziprasidone (Geodon®), are being studied
as possible treatments for bipolar disorder. Evidence suggests
clozapine may be helpful as a mood stabilizer for people who
do not respond to lithium or anticonvulsants. Other research
has supported the efficacy of olanzapine for acute mania, an
indication that has recently received FDA approval. Olanzapine
may also help relieve psychotic depression.
If insomnia is a problem, a high-potency benzodiazepine medication
such as clonazepam (Klonopin®) or lorazepam (Ativan®)
may be helpful to promote better sleep. However, since these
medications may be habit-forming, they are best prescribed on
a short-term basis. Other types of sedative medications, such
as zolpidem (Ambien®), are sometimes used instead.
Changes to the treatment plan may be needed at various times
during the course of bipolar disorder to manage the illness
most effectively. A psychiatrist should guide any changes in
type or dose of medication. Be sure to tell the psychiatrist
about all other prescription drugs, over-the-counter medications,
or natural supplements you may be taking. This is important
because certain medications and supplements taken together may
cause adverse reactions. To reduce the chance of relapse or
of developing a new episode, it is important to stick to the
treatment plan. Talk to your doctor if you have any concerns
about the medications.
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| Thyroid
Function |
People
with bipolar disorder often have abnormal thyroid gland function.
Because too much or too little thyroid hormone alone can lead
to mood and energy changes, it is important that thyroid levels
are carefully monitored by a physician.
People with rapid cycling tend to have co-occurring thyroid
problems and may need to take thyroid pills in addition to their
medications for bipolar disorder. Also, lithium treatment may
cause low thyroid levels in some people, resulting in the need
for thyroid supplementation. |
| Medication
Side Effects |
Before
starting a new medication for bipolar disorder, always talk
with your psychiatrist and/or pharmacist about possible side
effects. Depending on the medication, side effects may include
weight gain, nausea, tremor, reduced sexual drive or performance,
anxiety, hair loss, movement problems, or dry mouth. Be sure
to tell the doctor about all side effects you notice during
treatment. He or she may be able to change the dose or offer
a different medication to relieve them. Your medication should
not be changed or stopped without the psychiatrist's guidance.
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