Treatments for Bipolar Disorder:
Medications
How can medications help control bipolar disorder?
The medications that have been found to help control bipolar
disorder include mood stabilizers, anitdepressants, and anti-psychotic
medicines.
Mood stabilizers include lithium, divalproex sodium
(Depakote) and carbamazepine (Tegretol). These
medications can be used to stop mania when given in high
doses. In some cases, they may also help stop or lessen the
severity of depression. These medications are also used to
prevent or lessen the severity of episodes of mania or depression.
The medications are taken continuously in the hopes of making
it less likely for a person to get new episodes and/or make
the new episodes that occur less severe. Frequently, these
medications tend to be better at stopping or preventing mania
than they are at stopping or preventing depression.
Other medications that can be used as mood stabilizers (or to treat mania)
include clonazepam (Klonopin) and neuroleptic agents like risperidone
(Risperdal) and olanzapine (Zyprexa). Other medications, like
gabapentin (Neurontin) and lamotrigine (Lamictal), are being
researched for their mood stabilizing abilities.
Some people get good responses to mood stabilizers. In many others, the symptoms
do not completely go away. They do, however, get less intense and more managable
so that the quality of the person's life improves. Often, people need to take
more than one medication at a time for maximal benefit.
Antidepressants include fluoxetine (Prozac),
sertaline (Zoloft), paroxetine (Paxil), bupropion
(Wellbutrin), nefazodone (Serzone), venlafaxine
(Effexor), and others. These medications may be used
in combination with mood stabilizers to treat depression.
It is generally not appropriate for a person with bipolar
disorder to take antidepressants alone without mood stabilizers
because antidepressants without mood stabilizers increase
the risk of the occurence of a manic episode. Even with mood
stabilizers, there is a significant risk of causing mania
or a long-term rapid-cycling course. Bupropion and paroxetine
are the two antidepressants that have been shown in double-blind,
controlled studies to have a somewhat lower risk of causing
acute mania. Thus, we recommend using antidepressants mainly
to treat acute major depression with mood stabilizers. Once
a depression has resolved, mood stabilizers are the best
proven treatments to prevent future depression. Antidepressants
may need to be tapered after acute depression has resolved,
in order to avoid a long-term rapid-cycling course.
More information on specific uses and side effects of medications is available
in pamphlets from your physician.
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