Bipolar II Disorder
What Are the Treatments for Bipolar II Disorder? continued...
Valproate (Depakote): This antiseizure drug also works to level out moods. It has a more rapid onset of action than lithium, and it can also be used "off label" for prevention of highs and lows.
Some other antiseizure medications, such as gabapentin (Neurontin), oxcarbazapine (Trileptal), and topiramate (Topamax) are also sometimes prescribed as "experimental" (less-proven) treatments for mood symptoms or associated features in people with bipolar disorder.
By definition, hypomanic episodes do not involve psychosis and do not interfere with functioning. Antipsychotic drugs, such as aripiprazole (Abilify), cariprazine (Vraylar), quetiapine (Seroquel), asenapine (Saphris), olanzapine (Zyprexa), risperidone (Risperdal), and ziprasidone (Geodon) and others, are nevertheless sometimes used in hypomania and some (notably, Seroquel) are used for depression in bipolar II disorder.
This class of drugs includes alprazolam (Xanax), diazepam (Valium), and lorazepam (Ativan) and is commonly referred to as minor tranquilizers. They are used for short-term control of acute symptoms associated with hypomania such as insomnia or agitation.
Seroquel and Seroquel XR are the only medications FDA-approved specifically for bipolar II depression. Common antidepressants such as fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft) are also sometimes used in bipolar II depression, and are thought to be less likely to cause or worsen hypomania than is the case in bipolar I disorder. Other medicines sometimes used to treat bipolar II depression include mood stabilizers such as lithium or Depakote, and occasionally Lamictal (although the proven value of Lamictal in bipolar disorder is stronger for preventing relapses than treating acute episodes of bipolar depression). Psychotherapy, such as cognitive-behavioral therapy, may also help.
Because bipolar II disorder typically involves recurrent episodes, continuous and ongoing treatment with medicines is often recommended for relapse prevention.
Can Bipolar II Disorder Be Prevented?
The causes of bipolar disorder are not well understood. It's not known if bipolar II disorder can be prevented entirely.
It is possible to reduce the risk for developing future episodes of hypomania or depression once bipolar disorder has developed. Regular therapy sessions with a psychologist or social worker, in combination with medication, can help efforts to stabilize mood, leading to fewer hospitalizations and feeling better overall. Psychotherapy can help people better recognize the warning signs of a developing relapse before it takes hold, and can also help to ensure that prescribed medicines are being taken properly.