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    Maintenance Treatment for Bipolar Disorder

    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 -- sometimes at lower doses.

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    What Is the Bipolar Spectrum?

    The bipolar spectrum is a term used to refer to conditions that include not only bipolar disorder as traditionally defined (that is, clear episodes of mania or hypomania as well as depressive syndromes) but also other types of mental conditions that can involve depression or mood swings without manic or hypomanic episodes -- including some impulse control disorders, anxiety disorders, personality disorders, and forms of substance abuse. Some psychiatrists find the "bipolar spectrum" concept to be...

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    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.

    Aripiprazole (Abilify), lamotrigine (Lamictal),  lithium olanzapine (Zyprexa),  risperidone (Risperdal) Consta, and  quetiapine (Seroquel) or  ziprasidone (Geodon), (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.

    These drugs include:

    A combination of these drugs may also be used.

    Lamotrigine (Lamictal) for Bipolar Disorder

    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.

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