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Medication for Bipolar Disorder

This is information about drugs that can be used as part of the treatment of bipolar disorder. It is important to be well informed about prescription medications you are taking, but this is not a "do-it-yourself" manual. Self-medication can be dangerous. Interpretation of both the signs and symptoms of bipolar disorder, and medication side effects, are jobs for the professional. The prescription and management of medication, in all cases, must be done by a responsible physician, working closely with the patient and his/her treating psychologist, and sometimes involving the patient's family.  This is the only way to ensure that the most effective use of medication is achieved with minimum risk of side effects or complications.

Oftentimes an individual is taking more than one medication and at different times of the day. It is essential to take the correct dosage of each medication. An easy way to ensure this is to use a 7-day pill box, available at the prescription counter in any pharmacy, and to fill the box with the proper medications at the beginning of each week.

Overview

Three groups of antidepressant medications are most often used to treat depressive disorders: tricyclics, monoamine oxidase inhibitors (MAOIs), and lithium. Lithium was the treatment of choice for bipolar disorder and some forms of recurring, major depression. However, more recently doctors have also been using anticonvulsants for bipolar disorder. Your physician must consider your personal health history and response to medications in determining what is best for you. Sometimes different medications are tried, and sometimes the dosage must be increased to be effective.

People often are tempted to stop medication too soon. It is important to keep taking medication until your doctor says to stop, even if you feel better beforehand. Some medications must be stopped gradually to give your body time to adjust. For individuals with bipolar disorder, medication may have to become part of everyday life to avoid disabling symptoms. That is, antimanic medications are designed to stop a manic episode in progress, but they are also preventative. Taking the medication helps prevent another manic episode. Depending on the frequency and severity of episodes, your physician may recommend ongoing treatment with antimanic medication to prevent future episodes. 

As is the case with any type of medication prescribed for more than a few days, antimanic medications have to be carefully monitored to see if you are getting the correct dosage. Your doctor will want to check the dosage and its effectiveness regularly.

Never mix medications of any kind--prescribed, over-the counter, or borrowed--without consulting your doctor. Be sure to tell your dentist or any other medical specialist who prescribes a drug if you are taking antimanic medication. Some of the most benign drugs when taken alone can cause severe and dangerous side effects if taken with others. Be sure to call your doctor if you have a question about any drug or if you are having a problem you believe is drug related. Also, never take alcohol with medications of any kind, unless your physician has told you it is safe to do so. Alcohol interacts with many different medications.

Symptom Relief, Not Cure

Just as aspirin can reduce a fever without clearing up the infection that causes it, psychotherapeutic medications act by controlling symptoms. Like most drugs used in medicine, they correct or compensate for some malfunction in the body. Psychotherapeutic medications do not cure mental illness. In many cases, these medications can help a person get on with life despite some continuing difficulty coping with problems. In the case of bipolar disorder, the antimanic medications help control, or minimize the effects of a manic episode.  However, the person still has to learn self-monitoring skills, to identify an episode as it is developing, and psychotherapy is helpful to learn to adjust to the limitations of the disorder, as well as focusing on depressive symptoms and issues. 

How long someone must take a psychotherapeutic medication depends on the disorder. Many depressed and anxious people may need medication for a single period perhaps for several months and then never have to take it again. But. for manic-depressive illness, medication may have to be take indefinitely or, perhaps, intermittently.

Like any medication, psychotherapeutic medications do not produce the same effect in everyone. Some people may respond better to one medication than another. Some may need larger dosages than others do. Some experience annoying side effects, while others do not. Age, sex, body size, body chemistry, physical illnesses and their treatments, diet, and habits such as smoking, are some of the factors that can influence a medication's effect.

Questions for Your Doctor

To increase the likelihood that a medication will work well, patients and their families must actively participate with the doctor prescribing it. You must tell the doctor about your past medical history, other medications being taken, anticipated life changes such as planning to have a baby and, after some experience with a medication, whether it is causing side effects. When a medication is prescribed, you should ask the following questions, recommended by the US Food and Drug Administration (FDA):

  • What is the name of the medication, and what is it supposed to do?
  • How and when do I take it, and when do I stop taking it?
  • What foods, drinks, other medications, or activities should I avoid while taking the prescribed medication?
  • What are the side effects, and what should I do if they occur?
  • Is there any written information available about the medication?

Here, medications are described by their generic (chemical) names and by their trade names (brand names used by drug companies). This page describes antimanic medications.

Treatment evaluation studies have established the efficacy of the medications described here; however, much remains to be learned about these medications. The National Institute of Mental Health, other Federal agencies, and private research groups are sponsoring studies of these medications. Scientists are hoping to improve their understanding of how and why these medications work, how to control or eliminate unwanted side effects, and how to make the medications more effective.

 


Information about medication for depression and bipolar disorder:

Overview of Bipolar Medications

Description of Antimanic Medications

Medication Precautions in Treating Bipolar Disorder

Medication as Part of the Treatment of Depression