Understanding Bipolar Disorder -- Treatment
At present, bipolar disorder is treated with three main classes of medication, mood stabilizers, antipsychotics, and antidepressants. Most often treatment employs a combination of at least one mood-stabilizing drug and/or atypical antipsychotic plus psychotherapy. The most widely used drugs for the treatment of bipolar disorder include lithium carbonate and valproic acid (also known as divalproex). Carbamazepine and lamotigine are among other antiepileptic agents used to treat bipolar disorder as well. Other antiepileptic drugs, such as gabapentin, oxcarbazepine, or topiramate, are regarded as experimental treatments that are not well-established but may sometimes have value for bipolar disorder. Antipsychotic agents, such as olanzapine, aripiprazole, risperidone and others, are FDA-approved for the treatment of bipolar disorder. Often they are used to manage psychotic symptoms, which can accompany manic or depressive episodes, but they are also used to stabilize mood.
8 Myths About Bipolar Disorder
Because of increased awareness and diagnosis, more people than ever before have a basic understanding of bipolar disorder, the condition formally known as manic depression. Yet myths persist about this mental disorder that causes mood shifts from depression to mania and affects a person's energy and ability to function. WebMD asked five bipolar disorder experts to help unravel what's myth and what's fact. Read on for the eight common myths about bipolar they often hear from patients and the...
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The family or spouse of a patient should be involved with any treatment. Having full information about the disease and its manifestations is important for both the patient and loved ones.
Lithium carbonate has historically been the principal drug used in treating bipolar disorder. It can be remarkably effective in reducing mania, although doctors still do not know why. Lithium may also prevent recurrence of depression, but its value seems greater against mania than depression and therefore it is often given in conjunction with other medicines known to have greater value for depression symptoms, including antidepressants. Other mood stabilizers that have proved helpful in treating the manic or mixed phases of the illness include valproic acid and carbamazepine. These drugs may be used alone or in combination with lithium to control symptoms. In addition, newer drugs are coming into the picture when traditional medications are insufficient. Lamotrigine has been shown to have value for preventing recurrences of either manias or depressions, but is especially useful against depressions.
When the depressive phase of bipolar disorder occurs, an antidepressant is sometimes used along with a mood stabilizer, although the FDA-approved treatments for bipolar depression are actually quetiapine or olanzapine-fluoxetine combination. If a traditional antidepressant is going to be used, selective serotonin reuptake inhibitors (SSRIs) -- specific to the brain chemical serotonin -- are sometimes preferred, as is the drug bupropion, because these agents have fewer side effects than older drugs and have at least preliminary research supporting their use in bipolar depression.
Among the SSRIs are Paxil, Prozac, Celexa, Lexapro, and Zoloft. Other antidepressants include the tricyclics -- such as desipramine, imipramine, and amitriptyline, although these are used infrequently. Newer antidepressants include Effexor, Cymbalta, and Remeron, but these have not yet been studied for bipolar depression. In general, your doctor may try to keep the use of antidepressants limited and brief if possible, since prolonged use may actually trigger a manic episode or cause cycles to be more rapid.
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