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Bipolar Disorder: Managing Mania

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Treatments for Mania in Bipolar Disorder

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Anticonvulsant Drugs for Bipolar Disorder

Several specific anticonvulsant drugs -- Depakote, Tegretol and Lamictal -- are used as mood stabilizers to treat or prevent the mood symptoms of bipolar disorder. Doctors discovered this use for the drugs when they noted improvements in mood stability among people with epilepsy. At first, anticonvulsants were prescribed only for people who did not respond to lithium. Today, they are often prescribed alone, with lithium, or with an antipsychotic drug to control mania or prevent recurrent episodes.  There are also several other anticonvulsant drugs -- such as Trileptal, Topamax, and Neurontin -- which are not proven treatments for mood symptoms in bipolar disorder, but are nevertheless sometimes prescribed by doctors either experimentally or for symptoms other than mood (such as anxiety or pain).

What It Is: Anticonvulsants are drugs prescribed to calm hyperactivity in the brain in various ways. For this reason, some of these drugs are used to treat epilepsy, prevent migraines, and treat other mental disorders. They are sometimes favored over lithium or used in combination with lithium or antipsychotic drugs for people who have rapid cycling -- four or more episodes of mania and depression in a year.

What to Expect: Each anticonvulsant acts on the brain in slightly different ways, so your experience may differ depending on the medicine you take. In general, however, these medicines take at least several weeks or longer to judge their effect.

Your doctor may want to take regular blood tests to monitor your health. Some anticonvulsants can affect the enzymes made by your liver or decrease the amount of platelets in your blood. Liver enzymes are needed to metabolize (process) body toxins or drugs. Your blood needs platelets to clot.

Risks and Side Effects: Each anticonvulsant may have slightly different side effects.

Here are common side effects of anticonvulsants:

  • Dizziness
  • Drowsiness
  • Fatigue
  • Nausea
  • Tremor
  • Rash
  • Weight gain

Most of these side effects lessen with time.

Serious risks include:

  • Birth defects: Pregnant women should not take anticonvulsants without consulting with their doctor, because they may cause birth defects.
  • Liver problems: If you take anticonvulsants for the long term, your doctor may require blood tests to monitor your liver.
  • Drug interactions: Anticonvulsants can interact dangerously with other drugs -- even aspirin or oral contraceptives -- or make those other drugs work less effectively. Be sure to tell your doctor about any medicines, herbs, or supplements you take. Don't take any other substance during treatment without talking with your doctor.
  • Stevens-Johnson syndrome: A potentially life-threatening skin rash

 

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