In bipolar disorder, after remission from an acute episode of mania or depression, a person is at an especially high risk of relapse for about six months. Thus, continuation and maintenance of (ongoing) therapy is often recommended as treatment for bipolar disorder.
Anyone who has experienced two or more episodes of bipolar disorder generally is considered to have lifelong bipolar disorder, where the goal focuses not only on treating current symptoms but also preventing future episodes. That person should have maintenance therapy. Once your doctor has helped stabilize the moods of the acute phase of the disorder (either a manic or depressive episode), drug therapy is continued indefinitely -- often at lower doses.
No one's mood is stable 100% of the time. It's normal to feel down when you hit a rough patch and elated when life goes your way.
But if you have bipolar disorder, the highs and lows are a lot more extreme, and they can sometimes seem random. The good news is that with treatment and some hard work, you can control the impact this disease has on your life.
It is important to remember this: Even if you have been without bipolar symptoms for several months, do not stop taking your medications. Your doctor may lower your doses, but discontinuation of medications will put you at risk for recurrence of bipolar symptoms.
Lamotrigine, lithium, olanzapine, aripiprazole, risperidone Consta, and quetiapine or ziprasidone (either one in combination with lithium or valproate) are the only drugs that have been approved by the FDA specifically for maintenance therapy for bipolar disorder. These medications can differ in their ability to prevent manic versus depressive episodes, as well as in their side effects. However, many other drugs used to treat manic episodes are also used for maintenance treatment.
Lamictal is approved by the FDA for the maintenance treatment of adults with bipolar disorder. It has been found to help delay bouts of depression, mania, hypomania (a milder form of mania), and mixed episodes in those being treated with standard therapy. It is especially effective in the prevention of bipolar depression. It is the first FDA-approved therapy since lithium for maintenance in bipolar disorder.
Lamictal is considered a mood-stabilizing anticonvulsant and is most commonly prescribed to prevent or control seizures in the treatment of epilepsy. Recent studies have shown it may possess antidepressant effects in bipolar disorder.