Rocking your bipolar disorder journey
Comprehensive Guide to Prescription Drugs for Bipolar Disorder
Navigating bipolar disorder doesn't have to be a daunting task. Medication will likely play a significant role in your treatment plan, serving as a vital tool to keep those manic highs and crushing lows at bay. Like a diabetic needing insulin to maintain stability, taking medication for bipolar disorder aids in mood maintenance.
Closely collaborate with a specialist and don't hesitate to re-evaluate your medication regularly. Remember, this is merely one aspect of a successful treatment program. Embracing healthy lifestyle changes, creative self-help strategies, and exploring therapy can further support your bipolar management journey.
Maximizing bipolar disorder medication
Beat the blues, the right way
Avoid antidepressants when treating bipolar depression. They can worsen or even trigger a manic episode. Latch onto mood stabilizers first, and never play with fire by taking antidepressants without them.
Embrace the power of natural mood-boosters
Your lifestyle matters! Making healthy daily choices could potentially mean reduced medication needs. Opt for mood stabilizers like sleep consistency, regular exercise, relaxation techniques, and a strong support system—all without needing a prescription!
Add therapy to your treatment toolkit
Integrating therapy into your treatment plan has powerful benefits. Research shows individuals recover faster and maintain steadier moods when they incorporate therapy. This mental toolbox equips you to cope with life’s challenges, monitor your progress, and tackle issues caused by bipolar disorder in your personal and professional life. Sessions can be conducted in-person or online.
Stick with your meds, even when you feel better
Relapses can be pretty high if you decide to stop your medication. Abruptly halting meds is risky; consult your doctor before making any changes, even if you think your symptoms have subsided. Your doctor can help you transition safely.
Finding the perfect medication
Finding the ideal medication for you takes time and patience. Since we're all unique, your response to medication could differ from someone else’s. It may require trying several drugs before discovering the one that works best for you. Endure the process, but don't settle for a drug that makes you feel lousy.
Once you find the winning drug or combination, nailing the optimal dose could take time. With mood-stabilizing medications like lithium, the difference between an effective dose and a toxic one is subtle. Regular appointments with your doctor and close monitoring of your symptoms and side effects are essential to staying safe.
A learning experience
When starting a new medication, delve into its safety guidelines. Questions to ask your doctor may include:
- Are there any underlying medical conditions causing or worsening my mood swings?
- What are the potential side effects and risks of the medication you're recommending?
- When and how should I take this medication?
- Are there any diet or other substance restrictions I'll need to follow?
- How will this medication interact with my other prescriptions?
- How long will I need to take this medication?
- Will withdrawing from the medication be difficult if I choose to stop?
- Will my symptoms return if I stop the medication?
Catching up with the doc
During acute manic or depressive episodes, weekly doctor visits are necessary to monitor symptoms, medications, and any side effects. Once stabilized, fewer visits may be required. However, it's crucial to see your doctor promptly if you notice signs like suicidal or hostile feelings, changing moods, altered sleep patterns, or increases in side effects from your bipolar medication.
Generic vs. brand-name
Generic drugs share the same purpose, dosage, side effects, risks, safety profile, and potency as their brand-name counterparts. Brand-name medications might have different coatings or color dyes, which could lead to the generic version being less tolerable, but in most cases, generic drugs are just as effective and cost-friendly.
Taking your meds responsibly
All medications involve risk, but you can minimize the risks by taking bipolar disorder medications as prescribed and combining them with therapy and healthy lifestyle choices.
Follow instructions
Talk to your doctor before making any medication changes, even if the drug doesn't sit well or seems ineffective. Alternatives might be available. If medication isn't your thing, your doctor can help you taper off sensibly.
Note side effects
Track any side effects, timing, and severity in a log. Share this log with your doctor, who may suggest ways to minimize side effects, recommend a different medication, or adjust your dose.
Watch for drug interactions
Always check for drug interactions before taking any new medications, over-the-counter drugs, or supplements. Mixing certain substances can lead to unexpected side effects or make your bipolar medications less effective or even dangerous.
Tips for safe medication management
- Utilize alerts or reminders to ensure timely medication intake.
- Discard unused medications.
- Make other healthy lifestyle changes alongside medication use.
- Limit or discontinue alcohol consumption.
Lithium: The trusty mood-stabilizer
Mood stabilizers help control the highs and lows of bipolar disorder, serving as the foundation of treatment for both mania and depression. Lithium is the older and well-known mood stabilizer, highly effective for mania control, and can also aid bipolar depression, although it's less effective with mixed episodes or rapid cycling. Lithium reaches full potency within one to two weeks.
Lithium's common side effects
Some side effects might subside as your body adapts to the medication.
- Weight gain
- Fatigue
- Tremor
- Limpness or weakness
- Excessive thirst; frequent urination
- Stomach pain
- Thyroid problems
- Memory and concentration issues
- Giddiness, vertigo
- Diarrhea
The importance of regular blood tests
For lithium users, frequent blood tests are essential to ensure your dose falls within the therapeutic range. High doses can be toxic. When starting lithium, your doctor may check your blood levels once or twice a week. Once the right dose is determined, you'll still need blood tests every two to three months. Things like weight changes, salt intake, seasonal changes, and other medications can cause lithium levels to fluctuate.
Preventing toxic lithium levels
- Regular blood tests
- Maintain a consistent salt intake
- Hydrate properly (8 to 10 glasses of water daily)
- Avoid alcohol, which promotes dehydration
- Keep your caffeine consumption constant
- Inform any doctor or pharmacist you're on lithium when starting new medications
Anticonvulsant mood stabilizers for bipolar disorder
Originally developed to treat epilepsy, anticonvulsants have demonstrated efficacy in managing mania and reducing mood swings.
Valproic acid (Depakote)
Valproic acid, or divalproex (valproate), is an effective mood stabilizer. Popular brand names include Depakote and Depakene. Valproic acid is often the first choice for rapid cycling, mixed mania with hallucinations or delusions, and cases where lithium cannot be tolerated.
Common side effects include:
- Drowsiness
- Weight gain
- Dizziness
- Tremor
- Diarrhea
- Nausea
Other anticonvulsant options
- Carbamazepine (Tegretol)
- Lamotrigine (Lamictal)
- Topiramate (Topamax)
Antidepressant medications for bipolar disorder
Though antidepressants have traditionally been used for bipolar depression episodes, their safety and effectiveness are under scrutiny.
Proceed with caution
Antidepressants aren't particularly effective for bipolar depression.[6] A growing body of research calls into question their safety and efficacy. Also, antidepressants can trigger mania in people with bipolar disorder. If antidepressants are used, they should be combined with a mood stabilizer like lithium or valproic acid. Using an antidepressant without a mood stabilizer could lead to a manic episode.
Bipolar depression management with mood stabilizers
The new focus in bipolar depression treatment is optimizing mood stabilizer doses. By halting mood cycling, depressive episodes may cease entirely. If depressive symptoms persist despite cycling control, the following medications may help:
- Lamictal (lamotrigine)
- Seroquel (quetiapine)
- Zyprexa (olanzapine)
- Symbyax (a combination of olanzapine and the antidepressant fluoxetine)
Dealing with antidepressant-induced sexual dysfunction
Sexual and erectile dysfunction is a common side effect of antipsychotic medications, often preventing individuals from continuing their medication regimen. However, a 2006 study in Vellore, India concluded that the medication sildenafil (Viagra) is safe and effective for the treatment of antipsychotic-induced erectile dysfunction in men.[7]
Antipsychotic medications for bipolar disorder
If you experience breaks from reality during a manic or depressive episode, an antipsychotic drug might be prescribed. They have also been found to help with regular manic episodes. Antipsychotic medications can provide relief when other mood stabilizers fail. Often antipsychotic medications are combined with a mood stabilizer such as lithium or valproic acid.
Antipsychotic medications used for bipolar disorder include:
- Olanzapine (Zyprexa)
- Quetiapine (Seroquel)
- Risperidone (Risperdal)
- Aripiprazole (Abilify)
- Ziprasidone (Geodon)
- Clozapine (Clozaril)
Common side effects of bipolar disorder antipsychotics
- Drowsiness
- Weight gain
- Sexual dysfunction
- Dry mouth
- Constipation
- Blurred vision
Tackling antipsychotic-induced sexual dysfunction
Erectile dysfunction and sexual dysfunction are common side effects of antipsychotic medications, which often deter bipolar disorder patients from continuing their medication regimen. However, a 2006 study in Vellore, India concluded that the medication sildenafil (Viagra) is safe and effective in the treatment of antipsychotic-induced erectile dysfunction in men.[7]
Additional bipolar medications
Your doctor may recommend options like benzodiazepines, calcium channel blockers, or thyroid medications.
Benzodiazepines
Primarily used for anxiety, insomnia, or agitation management, benzodiazepines are fast-acting sedatives that start working within 30 minutes to an hour. Since they have a high addictive potential, benzodiazepines should be limited to use until your mood stabilizer or antidepressant begins to take effect—particularly for individuals with a history of substance abuse.
Calcium channel blockers
Typically used to treat heart issues or hypertension, they can also stabilize mood. While they are less potent than traditional mood stabilizers, calcium channel blockers boast fewer side effects. They could be an option for those who can't tolerate lithium or anticonvulsants.
Thyroid medication
Bipolar disorder patients often have abnormal thyroid hormone levels, particularly rapid cyclers. Lithium treatment can also trigger low thyroid levels. In these instances, thyroid medication may be added to the drug treatment regimen. The role of thyroid medication in bipolar disorder treatment is still under investigation, but it shows promise for managing bipolar depression with minimal side effects.
Embracing a holistic approach
Bipolar medication functions optimally when combined with other bipolar disorder treatments like therapy, self-help coping strategies, and lifestyle modifications. Remember, you're the master of your journey, and taking charge of your well-being can lead to a fulfilling life.
Connect with a qualified therapist to begin your bipolar disorder management journey, using BetterHelp's online therapy service to get matched with an accredited therapist in 48 hours or less.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5765441/[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2288657/[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3270120/[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2893883/[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2899916/[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3474314/[7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1750884/
- To maximize the effectiveness of bipolar disorder medication, consider holistic approaches like therapy, mental-health strategies, and nutritional adjustments.
- Integrate a healthy lifestyle, including regular exercise, sleep consistency, relaxation techniques, and a strong support system, to potentially reduce medication needs and promote overall mental-health-and-wellness.
