Medication Precautions - Bipolar Disorder
Special Considerations
Children, the elderly, and pregnant or nursing women have special concerns and needs when taking psychotherapeutic medications. Some effects of medications on the growing body, the aging body, and the childbearing body are known, but much remains to be learned. Research in these areas is ongoing.
Children
There are many treatments that can help children. This includes medication, but psychotherapy, behavioral therapy, social skills training, family therapy, and group therapy should be explored before deciding to prescribe medications for children. The therapy used for an individual child is based on the child's diagnosis and individual needs.
When the decision is reached that a child should take medication, active monitoring by all caretakers (parents, teachers, others who have charge of the child) is essential. Children should be watched and questioned for side effects (many children, especially younger ones, do not volunteer information). They should also be monitored to see that they are actually taking the medication and taking the proper dosage. The long term effects of many psychotherapeutic medications on children is not known, especially in newly developed medications.
The Elderly
Persons over the age of 65 make up 12 percent of the population of the United States, yet they receive 30 percent of prescriptions filled. The elderly generally have more medical problems and often are taking medications for more than one of these problems. In addition, they tend to be more sensitive to medications. Even healthy older people eliminate some medications from the body more slowly than younger persons and therefore require a lower or less frequent dosage to maintain an effective level of medication.
The elderly may sometimes accidentally take too much of a medication because they forget that they have taken a dose and take another dose. The use of a 7-day pill box is especially helpful to an elderly person.
The elderly, and their friends, relatives, and caretakers, need to pay special attention and watch for adverse (negative) physical and psychological responses to medication. Because they often take more medications (including prescription drugs, over-the-counter preparations, and home or natural remedies) the possibility of negative drug interactions is higher.
Pregnant, Nursing, or Childbearing-Age Women
In general, during pregnancy, all medications (including psychotherapeutic medications) should be avoided where possible, and other methods of treatment should be tried.
A woman who is taking a psychotherapeutic medication and plans to become pregnant should discuss her plans with her doctor; if she discovers that she is pregnant, she should contact her doctor immediately. During early pregnancy, there is a possible risk of birth defects with some of these medications, and for this reason:
1) Lithium is not recommended during the first 3 months of pregnancy.
2) Benzodiazepines are not recommended during the first 3 months of pregnancy.
The decision to use a psychotherapeutic medication should be made only after a careful discussion with the doctor concerning the risks and benefits to the woman and her baby.
Small amounts of medication pass into the breast milk. This is a consideration for mothers who are planning to breast-feed.
A woman who is taking birth-control pills should be sure that her doctor is aware of this. The estrogen in these pills may alter the breakdown of other medications by the body.
For more detailed information, talk to your doctor or mental health professional, consult your local public library, or write to the pharmaceutical company that produces the medication or contact:
US Food and Drug Administration
5600 Fishers Lane
Rockville, MD 20857
Information about medication for depression and bipolar disorder:
Overview of Bipolar Medications