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Bipolar Disorder Health Center

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Bipolar I Disorder

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What Are the Treatments for Bipolar I Disorder? continued...

Antidepressants

Common antidepressants such as fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft) have not been shown to be as effective for treating depression in bipolar disorder as in unipolar depression. In a small percentage of people, they can also set off or worsen a manic episode in a person with bipolar disorder. For these reasons, the first-line treatments for depression in bipolar disorder involve medicines that have been shown to have antidepressant properties but also no known risk for causing or worsening mania. The three FDA-approved treatments for bipolar depression are lurasidone (Latuda), olanzapine-fluoxetine (Symbyax) combination, quetiapine (Seroquel) or quetiapine fumarate (Seroquel XR). Other mood-stabilizing treatments that are sometimes recommended for treating acute bipolar depression include lithium, Depakote, and Lamictal (although none of these later three medicines is FDA-approved specifically for bipolar depression). If these fail, after a few weeks a traditional antidepressant or other medicine may sometimes be added. Psychotherapy, such as cognitive-behavioral therapy, may also help.

People with bipolar I disorder (mania or depression) have a high risk for recurrences and usually are advised to take medicines on a continuous basis for prevention.

Electroconvulsive Therapy (ECT)

Despite its scary reputation, electroconvulsive therapy (ECT) is an effective treatment for both manic and depressive symptoms. ECT is seldom used to treat bipolar I disorder, but can be helpful if medicines fail or can't be used.

Can Bipolar I Disorder Be Prevented?

The causes of bipolar disorder are not well understood. It's not known if bipolar I disorder can be prevented entirely.

It is possible to lower the risk of episodes of mania or depression once bipolar disorder has developed. Regular therapy sessions with a psychologist or social worker can help people to identify factors that can destabilize mood (such as poor medication adherence, sleep deprivation, drug or alcohol abuse, and poor stress management), leading to fewer hospitalizations and feeling better overall. Taking medicine on a regular basis can help to prevent future manic or depressive episodes.

How Is Bipolar I Different From Other Types of Bipolar Disorder?

People with bipolar I disorder experience full episodes of mania -- the often severe abnormally elevated mood and behavior described above. These manic symptoms can lead to serious disruptions in life (for example, spending the family fortune, or having an unintended pregnancy).

In bipolar II disorder, the symptoms of elevated mood never reach full-blown mania. They often pass for extreme cheerfulness, even making someone a lot of fun to be around -- the "life of the party." Not so bad, you might think -- except bipolar II disorder usually involves extensive and disabling periods of significant depression, which can often be harder to treat than if episodes of hypomania had never occurred.

WebMD Medical Reference

Reviewed by Joseph Goldberg, MD on November 21, 2015
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