If you have been diagnosed with bipolar disorder, you need to be treated on an ongoing basis to stabilize your condition. In fact, you should be visiting a mental health professional quite regularly even if you feel fine. Treatment for bipolar disorder usually includes talk therapy and medication.
Your psychiatrist will most likely recommend medication as initial treatment to help alleviate your symptoms as first as possible. Once your symptoms have gone down to manageable levels, you will start to receive maintenance therapy to help reduce the risk of relapse.
Several types of medications are used to treat bipolar disorder, including antidepressants, mood stabilizers for bipolar disorder, and drugs that relieve stress and anxiety. Your doctor may prescribe one or a combination of medications for better results.
Finding the right medication is usually a case of trial and error. You may be required to change medications if the side effects are severe. Furthermore, it may take up to seven weeks to start seeing the full effects of the drugs.
This blog post discusses everything you need to know about bipolar disorder treatment. We cover everything from mood stabilizers for bipolar disorder to antipsychotic medications. Read on to learn more.
Mood Stabilizers for Bipolar Disorder
Mood stabilizers are a group of medications used for various reasons. Most notably, they are used to modulate a range of moods, both low (depression) and high (mania).
The term “mood stabilizer” is generally used to refer to any drug with antiseizure properties used to manage conditions with elements of emotional dysregulation such as impulse control disorders, bipolar disorder, and personality disorders.
It is not known how mood stabilizers for bipolar work, but it is believed that the stabilization of membrane concentration gradients within the patient’s brain prevents charged particles from flowing down the gradients to inhibit neural impulse.
This explains the ability of these drugs to alleviate maniac or depressive symptoms. In some cases, the mood stabilizers are combined with antidepressants to prevent episodes of mania or mixed episodes of mania and depression.
What Are the Best Mood Stabilizers for Bipolar Disorder?
No mood stabilizer can be regarded as the best for treating bipolar disorder. However, four main mood stabilizers have been proven to work best for bipolar disorder. Each one of them plays a unique role in alleviating bipolar disorder symptoms. The mood stabilizers are:
Lithium stands out as one of the best mood stabilizers for its preventive effects in bipolar disorder. It is the only mood stabilizer known to alleviate the risk of suicide hence reducing mortality among patients.
It also lowers the risk of heart disease, cancer, stroke, and other viral illnesses that may occur as a result of bipolar disorder. Patients with the bipolar I condition tend to respond best to lithium for bipolar disorder.
Depakote (divalproex) emerged as a new drug that could be used to treat certain symptoms of bipolar disorder such as mania and depression in 1990s. And while there is still no cure for the illness itself, doctors have found that when they combine Depakote with other medications such as lithium or valproate sodium they are able to significantly reduce symptoms associated with both types of episodes.
Depakote belongs to the class of drugs known as psychoactive drugs – those that change or affect brain function.
Depakote affects both manic and depressive symptoms because its primary action is on the neurotransmitter known as GABA; this works to regulate both depression and mania by slowing down central nervous system activity. Depakote thus acts as a mood stabilizer that will balance the highs and lows of bipolar disorder.
Tegretol has been around as a treatment for seizures and as a mood stabilizer since 1960s. In the 1980s, it was found to be effective at managing manic episodes associated with bipolar disorder; often when Depakote fails, doctors will switch to Tegretol instead.
The way Tegretol affects neurotransmitters in the brain is very similar to how Depakote works. It works at GABA, slowing down central nervous system activity and regulating moods so that they are neither too high nor too low.
The effects of using Lamictal are complex. While it does slow central nervous system activity, it also has an effect on serotonin – the neurotransmitter that is thought to regulate aggression.
It works in part by blocking the release of excess serotonin into the brain – something that can be useful for preventing or reducing aggression associated with mood swings.
Medications for Bipolar Depression
Not so long ago, the main treatment for bipolar depression was sedatives that had numerous side effects. Today, patients are mainly treated using mood stabilizing drugs with minimal side effects.
Lithium, anticonvulsants valproate and lamotrigine are the main medication bipolar depression treatment options. Most of these drugs are usually used as “off label” because none has an FDA approval for treating bipolar depression.
If the mood stabilizer is ineffective, your doctor may add an antidepressant to it. The mood stabilizers used to treat bipolar disorder depression mainly improve social interactions, behavior, and mood.
In some patients with bipolar disorder, all they need is a mood stabilizer to modulate their depressed mood. However, if the patient doesn’t respond to the mood stabilizer, an atypical antipsychotic may be added to the treatment regimen.
Medications for Bipolar Mania
There are two different types of drugs used to treat bipolar mania: anticonvulsants (such as Lamictal) and atypical antipsychotics (such as Zyprexa).
Anticonvulsants are used in the treatment of bipolar disorder as mood stabilizers. They help to control the manic and depressive episodes that can occur with bipolar disorder. Anticonvulsants work pretty quickly and may be used as the first treatment for people experiencing a manic episode.
Some of anticonvulsant medications administered to treat bipolar disorder include: carbamazepine, gabapentin enacarbil, phenobarbital, phenytoin,and topiramate.
These medications are given along with other psychiatric drugs. They may be prescribed to treat depression in bipolar disorder or a mixed episode. Anticonvulsants take effect quickly and can start alleviating bipolar symptoms within days or weeks. If these medications are not controlling your mood swings, your doctor may prescribe alternative medications.
Anticonvulsants do have side effects, such as dizziness, headaches and nausea. According to the National Institute of Mental Health (NIMH), serious side effects are possible with these medications, but they are considered to be quite safe.
2. Atypical antipsychotics (such as Zyprexa)
Atypical antipsychotics are sometimes referred to as “mood stabilizers.” Doctors prescribe atypical antipsychotics because they tend to be more effective than lithium and other mood stabilizers for severe mania, as well as for rapid cycling and mixed states (combinations of depression and mania).
Atypical antipsychotics also play a critical role in treating general depression. However, they are not widely used in treating bipolar depression because they can trigger mania or rapid cycling in some patients.
Antipsychotic and Mood Stabilizing Medications for Bipolar Disorder
Antipsychotic medications are mainly used to treat schizophrenia and other psychotic disorders. They work by blocking certain receptors in the brain. However, they can also be used to treat bipolar disorder.
Below are some of the common antipsychotic and mood stabilizing medications used to treat bipolar disorder.
Antipsychotic Medications Used to Treat Bipolar Disorder
The antipsychotic medications listed below are used to help control mood swings experienced by people with bipolar disorder. They are usually taken as tablets or capsules that are swallowed.
Quetiapine is more effective against mania but can also treat acute depressive episodes. While the stabilizer cannot claim the medical benefits that other drugs such as lithium offers, it assists with two critical symptoms that many patients find troubling; insomnia and anxiety.
Aripiprazole is known by the brand names Abilify, Aripiprex, Aristada and others. It’s an antipsychotic medication with mood stabilizing properties.
These medications work by blocking certain receptors in the brain. They also cause the release of higher levels of serotonin and dopamine than usual, which helps to improve mood.
Aripiprazole is used to treat bipolar disorder and schizophrenia. It’s also used to manage symptoms of irritability associated with autism. Aripiprazole may reduce the risk of suicide in people with bipolar disorder.
Another antipsychotic medication with mood stabilizing properties is asenapine, sold under the brand name Saphris.
Asenapine works by blocking certain receptors in the brain. These serotonin receptors contribute to many of the symptoms of bipolar disorder.
In the U.S., asenapine is usually given via injection into a muscle or with an oral solution taken by mouth.
Asenapine is used to treat manic and mixed episodes of bipolar disorder. It’s also sometimes used as a short-term treatment for rapid cycling mood disorders. In this case, it might be used along with other medications that help stabilize mood.
Bupropion is a non-nicotine aid used to treat major depressive disorder and seasonal affective disorder. It’s known by the brand names Zyban, Aplenzin and others. Bupropion works in the brain by increasing levels of dopamine and norepinephrine, which boosts mood.
Bupropion is also used off-label (meaning that the FDA hasn’t approved its use) to treat bipolar disorder. It’s mainly used as an add-on treatment if other medications don’t work or can’t be tolerated.
5. Cariprazine (Vraylar)
Another antipsychotic medication with mood-stabilizing properties is cariprazine, sold under the brand name Vraylar.
Like other antipsychotic medications, cariprazine works by blocking certain receptors in the brain that contribute to mood swings. Dopamine receptors are also linked to psychosis which is why many antipsychotics work by blocking them.
However, Vraylar isn’t approved for use in psychotic disorders like schizophrenia. It’s only approved for bipolar disorder. In the U.S., Vraylar is available as a tablet taken by mouth; it’s usually used when other medications have been unsuccessful or can’t be tolerated.
Get Support! Call the Depression Bipolar Support Alliance
If you are struggling with bipolar, you should know you are not alone. The good thing is that you can get the professional help you need. It’s important to know it takes time and effort, but the results are well worth it.
The Depression Bipolar Support Alliance offers support groups across the country for people with mood disorders, family members and loved ones.
Contact DBSA today to be connected with a peer-to-peer support group near you.