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Bipolar Disorder: Managing Mania

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Treatments for Mania in Bipolar Disorder

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Benzodiazepines and Bipolar Disorder

In bipolar disorder, benzodiazepines help rapidly control certain manic symptoms until mood-stabilizing drugs can take effect. They are usually taken for a brief time, up to two weeks or so, with other mood-stabilizing drugs. They may also help restore normal sleep patterns in people with bipolar disorder.

What It Is: Benzodiazepines slow the central nervous system. In doing so, they can help treat mania, anxiety, panic disorder, insomnia, and seizures.

Benzodiazepines prescribed for bipolar disorder include (among others):

  • Ativan (lorzepam)
  • Klonopin (clonazepam)
  • Valium (diazepam)
  • Xanax (alprazolam)

What to Expect: The drugs act quickly and bring on a sense of calmness. They can sometimes cause lightheadedness, slurred speech, or unsteadiness.

Risks and Side Effects: Benzodiazepines can be habit-forming and may cause physical dependence. They are also dangerous (or possibly even fatal) if combined with alcohol, and therefore people taking a benzodiazepine should not drink any alcohol.

Other side effects of benzodiazepines include:

  • Drowsiness or dizziness
  • Lightheadedness
  • Fatigue
  • Blurred vision
  • Slurred speech
  • Memory loss
  • Muscle weakness

Consult your doctor if you still take benzodiazepines to see if you still need them. If you have been taking the drugs for a long time, you may suffer withdrawal symptoms if you stop them suddenly. Talk with your doctor about how to taper off the drug.

Electroconvulsive Therapy (ECT) for Bipolar Disorder

Electroconvulsive therapy, also known as electroshock therapy or ECT, is used as an acute treatment for hospitalized patients who are suicidal, psychotic, or dangerous to others. It is effective in nearly 75% of patients who undergo it.

What It Is: In electroconvulsive therapy, an electric current is sent through the scalp to the brain. It is used to treat people who are suffering from severe depression or other mental illness. ECT is one of the fastest ways to relieve symptoms in people who suffer from mania or severe depression. ECT is generally used as a last resort when the illness does not respond to medicine or psychotherapy. It is also used when patients pose a severe threat to themselves or others and it is dangerous to wait until drugs take effect.

What to Expect: Prior to ECT treatment, a person is sedated using general anesthesia and a muscle relaxant is given. 

Electrodes are placed on the patient's scalp and a finely controlled electric current is applied that causes a brief seizure in the brain. Because the muscles are relaxed, the seizure will usually be limited to slight movement of the hands and feet. Patients are carefully monitored during the treatment. The patient awakens minutes later, does not remember the treatment or events surrounding the treatment, and is often confused.

This confusion typically lasts for only a short period of time. ECT is given up to three times a week for two to four weeks.

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