The most effective treatment for bipolar disorder is a combination of medication and psychotherapy. Most people take more than one drug, like a mood-stabilizing drug and an antipsychotic or antidepressant. However, it's important that treatment be ongoing -- even after you feel better -- to keep mood symptoms under control.
Research has not shown that antidepressants are as reliably safe and effective in people with bipolar disorder as in other forms of depression, making their use more controversial. Other types of medicines, including some mood stabilizers and certain atypical antipsychotics, are usually the first-line treatments for bipolar depression. The FDA has warned that antidepressants can increase the risk of suicidal thinking and behavior in children and adolescents with depression and other mental health disorders.
Anyone who has experienced two or more manic or hypomanic episodes generally is considered to have lifetime bipolar disorder. That person should have maintenance therapy to minimize the risk for future episodes. Once your doctor has helped stabilize the moods of the acute phase of the disorder (either a manic or depressive episode), medication therapy is usually continued indefinitely -- sometimes at lower doses.
Remember this: Even if you have been without bipolar symptoms for several months, do not stop taking your medications. Your doctor may lower your doses, but discontinuation of medications will put you at risk for recurrence of bipolar symptoms. Before stopping any medications, discuss it with your doctor.
