Medications are a key part of many treatment plans for bipolar disorder. Before starting any medications for bipolar disorder, always talk with your psychiatrist and/or pharmacist about possible side effects. If you do have side effects from your medications, your psychiatrist may be able to change the dose or offer a different medication to relieve them.
Bipolar medications are prescribed by psychiatrists with expertise in the diagnosis and treatment of mental disorders. While primary care physicians who do not specialize in psychiatry also may prescribe these medications, it is recommended that people with bipolar disorder see a psychiatrist for treatment.
For the treatment of bipolar disorder, "mood-stabilizing" medications generally are prescribed. Other medications are added when necessary, typically for shorter periods, to treat episodes of mania or depression that break through despite the mood stabilizer.
Be sure to tell your psychiatrist about all other prescription drugs, over-the-counter medications, or natural supplements you may be taking. This is important because certain medications and supplements taken together may cause adverse reactions.
Medications known as "mood stabilizers" are usually prescribed to help control bipolar disorder. Several different types of mood stabilizers are available. In general, people with bipolar disorder continue treatment with mood stabilizers for months or even years. Key points about these types of medication for bipolar disorder include:
- Lithium, the first mood-stabilizing medication approved by the U.S. Food and Drug Administration (FDA) in 1970 for treatment of mania, is often quite effective in controlling mania and preventing the recurrence of both manic and depressive episodes.
- Anticonvulsant medications, such as valproate (Depakene®, Depakote®, Depakote ER®) or carbamazepine (Carbatrol®, Epitol®, Equetro®, Tegretol®), also can have mood-stabilizing effects and may be especially useful for difficult-to-treat bipolar episodes. Valproate was FDA-approved in 1995 for treatment of mania.
- Newer anticonvulsant medications, including lamotrigine (Lamictal®), gabapentin (Neurontin®), and topiramate (Topamax®) (see Topamax for Bipolar Disorder), are being studied to determine how well they work for stabilizing mood cycles. Some of these medications, including Lamictal, are approved to treat bipolar disorder.
- Anticonvulsant medications may be combined with lithium or with each other for maximum effect.