How Is Bipolar Disorder Treated

How Is Bipolar Disorder Treated Bipolar Disorder Treatment Medications Print Treating Bipolar Disorder Medications, Therapy, and More By Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. Learn about our editorial policy Marcia Purse Medically reviewed by Medically reviewed by Steven Gans, MD on May 28, 2018 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on August 08, 2019 Bipolar Disorder Overview Symptoms & Diagnosis Causes Treatment Living With In Children Your Rights In This Article Table of Contents Expand Prescription Medications Psychological Therapies Complementary Treatments Lifestyle Changes Finding Treatment View All Bipolar disorder is typically a lifelong illness with episodes (especially if untreated) that are highly variable and unique to each individual. Treatment is complex and often involves more than one medication over time. Talk therapy, complementary medicine, and lifestyle modifications can also help, but psychiatric medications are the mainstay of treatment. Illustration by Emily Roberts, Verywell Prescription Medications Medications can help a person with bipolar illness manage their symptoms and function well in everyday life. A  person who has bipolar disorder tends to experience extreme highs (mania) and extreme lows (depression). Certain medications help stabilize your mood so you dont experience severe highs and lows. Since drug therapy is an important component of treatment for bipolar disorder, its important to educate yourself about the various medication options. A psychiatrist will choose which medications are likely to work best for your symptoms. At times, your medications may need to be adjusted or changed. If you have bipolar disorder and youre unhappy with the  medication  that youre currently onâ€"perhaps you feel like its not working well enough  or maybe youre experiencing a side effect that you simply cant standâ€"remember that its never a good idea to stop taking a medication cold turkey or change the dose of a medication without first talking to your doctor. If you need to switch medications, your physician or psychiatrist will advise you on how to do so safely. Anti-Convulsants Anticonvulsants, also known as anti-seizure medications, are sometimes used as mood stabilizers in bipolar disorder.   Carbamazepine  (Atretol, Tegretol, Epitol)Divalproex Sodium  (Depakote, Epival)Gabapentin  (Neurontin)Lamotrigine  (Lamictal)Oxcarbazepine  (Trielptal)Topiramate  (Topamax)Valproic Acid  (Depakene) Antipsychotics First generation antipsychotics, also known as typical antipsychotics, include: Chlorpromazine  (Thorazine)Haloperidol  (Haldol)Fluphenazine  (prolixin, permitil)Flupenthixol  (Fluanxol)Zuclopenthixol (Opixol) Atypical antipsychotics have fewer  extrapyramidal side effects  when compared to typical antipsychotics. But some, especially clozapine and olanzapine, carry a high risk of  metabolic syndrome. Atypical antipsychotics include: Aripiprazole  (Abilify)Clozapine  (Clozaril)Olanzapine  (Zyprexa)Risperidone (Risperdal)Ziprasidone  (Geodon)Quetiapine (Seroquel) Antidepressants Selective serotonin reuptake inhibitors, or SSRIs, are antidepressants that are commonly prescribed for major depressive disorder  but can also be prescribed for a bipolar depression. The SSRIs include: Citalopram  (Celexa)Escitalopram  (Lexapro, Cipralex)Sertraline  (Zoloft)Fluoxetine  (Prozac, Sarafem)Fluvoxamine  (Luvox)Paroxetine  (Paxil) The serotonin-norepinephrine reuptake inhibitors (SNRIs) include: Venlafaxine  (Effexor)Duloxetine  (Cymbalta)Desvenlafaxine  (Pristiq, Desfax) Tricyclic antidepressants are an older class of antidepressants that while effective for some people do carry a large side effect profile including heart arrhythmias and anticholinergic side effects like dry mouth, sedation, and constipation.   Amitriptyline  (Amitrip, Elevil, Endep, Levate, Amitril, Enovil)Amoxapine  (Asendin)Clomipramine  (Anafril)Desipramine  (Norpramin, Pertofrane)Doxepin  (Sinequan)Imipramine  (Tofranil)Nortriptyline  (Aventyl, Pamelor) Monoamine oxidase inhibitors (MAOIs) are an older class of antidepressant. They work by preventing the breakdown of monoamines in the brain, like dopamine, norepinephrine, and serotonin. Examples include: Phenelzine  (Nardil)Moclobemide  (Manerix)Tranylcypromine  (Parnate) There are also antidepressants that do not necessarily fit into the above categories, like Mirtazapine (Remeron), Trazodone (Oleptro, Desyrel), and  Bupropion  (Wellbutrin). Benzodiazepines Benzodiazepines depress a persons central nervous system and are used to treat anxiety, insomnia, and seizures. Benzodiazepines have different half-lives, meaning some are short-acting, intermediate-acting, or long-acting. They include: Alprazolam  (Xanax, Novo-alprazol,  Nu-alpraz)Clonazepam  (Klonopin, Rivotril)Chlordiazepoxide  (Librium, Libritabs)Diazepam  (Valium)Flurazepam  (Dalmane)Lorazepam  (Ativan)Oxazepam  (Serax)Temazepam  (Restoril)Triazolam  (Halcion) Other Medications There are a number of other medications used by people with bipolar disorder. Some are used quite commonly but do not necessarily fit into one of the common categories of psychiatric medication. One example is lithium  (Lithane, Lithobid, Lithonate, Eskalith, Cibalith-S, Duralith)â€"it is an element and was the first treatment for bipolar disorder. Although it requires careful monitoring, it is still commonly and effectively used as a first line mood stabilizer. On the other hand,  Verapamil  (Calan, Isoptin), is a blood pressure medication that has been tried experimentally in the treatment of mania. Combination Medications Sometimes your doctor will prescribe a single medication that combines two drugs. This may provide increased convenience, but less flexibility in adjusting the individual dosages. Three examples include: Triavil  (Amitriptyline/perphenazine)Limbitrol  (Amitriptyline/chlordiazepoxide)Symbyax  (Fluoxetine/olanzapine) Psychological Therapies Many symptoms of bipolar disorder  impact emotional well-being, so psychotherapy can often be helpful. Therapy sessions should take place with trained mental health professionalsâ€"they can help  identify when your moods are changing, triggers that lead to depressive or manic episodes, and skills to cope with bipolar disorder. They can also increase medication compliance, help you connect with others in the bipolar disorder community, and reduce any negative behaviors that affect your quality of life. There are several types of psychotherapy (talk therapy) that might be considered such as  cognitive behavioral therapy,  dialectical behavioral therapy, and family treatment. Involving loved ones in your treatment can help members of your family gain a better understanding of bipolar disorder and it can assist them in supporting your treatment. The Best Online Therapy Programs Complementary Treatments Its important to talk to your doctor before trying any alternative treatments. Herbal supplements, like  St. Johns Wort, could interfere with your medication or it may even trigger a manic episode.?? Studies have shown it may alleviate mild to moderate depression.?? Another complementary treatment for aspects of bipolar disorder is  phototherapy, also known as light box therapy. It is often used to treat seasonal depression. Evidence regarding the benefits of omega-3 fatty acids?? or acupuncture?? is inconsistent. There is not much data available clearly supporting the effectiveness of other alternative interventions in bipolar disorder (e.g., aromatherapy, massage therapy, yoga) although they may be beneficial in terms of general self-care. Before starting any type of alternative treatment, talk to your physician or psychiatrist. Lifestyle Changes Your doctor and therapist will likely talk to you about strategies to manage your lifestyle. Adequate sleep, exercise, and good nutrition can be key components in managing your symptoms. Its also important to manage your stress level. Developing healthy coping skills and helpful outlets for your stress can be key to regulating your mood. It may also be important to avoid drugs and alcohol. Mood altering substances tend to intensify the problems associated with bipolar disorder. Support can also be helpful in managing your symptoms. If you lack resources like supportive friends and a family, joining a support group for individuals with bipolar disorder may be especially important.   Finding Treatment Treatment for bipolar disorder can be initiated once a proper diagnosis is made. Your physician will likely refer you to a psychiatrist or other mental health professional. Be sure to speak openly with your physician and mental health professional about your symptoms, behaviors, moods, and anything else you notice in your daily life. Bipolar Disorder Discussion Guide Get our printable guide for your next doctors appointment to help you ask the right questions. Download PDF Bipolar disorder is best managed by a team of professionals. When those professionals work together to manage your symptoms, youll likely be able to experience remission.  With the right  treatment  plan, many people go for years and even decades being symptom-free. Remission is about gaining stability and keeping your bipolar disorder under control, and thats what most people who have bipolar disorder  are hoping forâ€"a productive and harmonious life. Achieving stability usually requires medication as part of the treatment plan. Living Well With Bipolar Disorder: Facing Stigma and More