Bipolar Disorder

Medicines, when taken as prescribed, can help control bipolar mood swings. Your doctor will vary the amounts and combinations of your medicines according to your symptoms, which Reference type of bipolar disorder you have, and how you respond to the medicines.

About 1 out of 3 people will be completely free of symptoms of bipolar disorder by taking Reference mood stabilizer medicine, such as carbamazepine or lithium, for life.^{Reference 5}

Taking medicines during pregnancy for bipolar disorder may increase the risk of birth defects. If you are pregnant or thinking of becoming pregnant, talk to your doctor. You may need to keep taking medicine if your bipolar disorder is severe. Your doctor can help weigh the risks of treatment against the risk of harm to your pregnancy.

Medication choices

Several medicines are used to treat bipolar disorder. It may take time to find the treatment that works best for you. The most common medicines used are:

• Reference Mood stabilizers, such as Reference lithium (Lithobid). Experts believe that lithium may affect certain brain chemicals (Reference neurotransmitters Opens New Window) that cause mood changes. A mood stabilizer and an antipsychotic are recommended as the first medicines for acute manic episodes.
• Anticonvulsants, such as carbamazepine (such as Equetro and Tegretol), divalproex (Depakote), and valproate (Depakene). They are also considered mood stabilizers. Divalproex and valproate are used to treat manic episodes. The anticonvulsant lamotrigine (Lamictal) may be helpful for bipolar depression.
• Reference Antipsychotics, such as aripiprazole (Abilify), olanzapine (Zyprexa), quetiapine (Seroquel), risperidone (Risperdal), and ziprasidone (Geodon). Antipsychotics improve Reference manic episodes. Olanzapine may be used in combination with other medicines.
• Reference Benzodiazepines Opens New Window, such as diazepam (Valium). These may be used instead of antipsychotics or as an additional medicine during a manic phase.

Medicines and your lifestyle

When you and your doctor are discussing your medicines, think about whether your lifestyle allows you to take medicines on time every day. A medicine you only take once a day may work best for you if you have a hard time remembering to take your medicines.

During your doctor's appointment, ask about:

• The side effects of each medicine.
• How often you will need to take the medicines.
• How the medicines may interact with other medicines you are taking.
• Whether it's important to take the medicines at the same time every day.

Monitoring medicines

You'll need to check in with your doctor regularly when taking medicines for bipolar disorder.

If you are prescribed carbamazepine, lithium, or valproate, you will need Reference regular blood tests to monitor the amount of medicine in your blood. Reference Too much lithium in your bloodstream may lead to serious side effects. Blood tests can also help show how medicines are affecting your liver, kidneys, and thyroid gland or to measure the number of blood cells in your body.

The use of Reference antidepressants alone has been linked to an increase in manic episodes. Antidepressant treatment needs to be monitored closely to avoid causing a manic episode.

FDA advisories

The U.S. Food and Drug Administration (FDA) has issued an Reference advisory on antidepressant and anticonvulsant medicines and the risk of suicide. The FDA does not recommend that people stop using these medicines. Instead, a person taking antidepressants should be watched for Reference warning signs of suicide, such as threatening to harm himself or herself and being preoccupied with death or suicide. This is especially important at the beginning of treatment or when doses are changed.

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This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Reference Terms of Use. Reference How this information was developed to help you make better health decisions.