Medications to Treat Bipolar Disorder

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Published Jul 14, 2023

Overview

Updated 5/16/2022

If you have bipolar disorder, medication may be an essential component of your bipolar disorder treatment plan as well as seeing an in-person or online psychiatrist. People who have bipolar disorder often experience changes in mood that can be either mild with irritability, agitation or severe with extreme anger, rage, and risky behaviors. They also tend to have wide swings in energy levels, behavioral traits, and attention spans.

The right bipolar medication can help stabilize mood changes while reducing other common bipolar disorder symptoms. Further, bipolar disorder medications can help prevent or reduce the severity of both manic and depressive episodes that are disruptive and interfere with daily life.

If you were recently diagnosed with depression or bipolar disorder and your symptoms are not being resolved to the point where you’re finding it difficult to manage day-to-day functioning, it’s time to discuss medication options with your psychiatrist. Finding the right combination of medications and other treatments like therapy can take some time. Most people find a combination of talk therapy and medication to be the most effective in treating their bipolar disorder. However, your mental health care provider will be able to create the best treatment plan tailored to your specific needs.

Read on to learn what you need to know about bipolar medications that can help you manage your daily life.

Types of Medications Used to Treat Bipolar Disorder

There are several types of medications for bipolar disorder. The following are some options to be aware of.

Antipsychotics

Antipsychotics are commonly prescribed for bipolar disorder when antidepressants or mood stabilizers aren’t effective in reducing or alleviating symptoms. Antipsychotics can be used either in combination with or in place of mood stabilizers.

Some antipsychotic drugs can help people with bipolar disorder by regulating different brain neurotransmitters and settling the brain circuit functioning that regulates mood, thinking, and perception. While it’s not totally understood how or why they work for bipolar disorder, antipsychotics can improve manic episodes quickly, which makes them a good option for some people.

Types of antipsychotics to treat bipolar disorder:

Zyprexa
Risperdal
Seroquel
Latuda
Abilify
Saphris
Vrylar
Geodon
Invega

Possible side effects of antipsychotics used to treat bipolar disorder:

Drowsiness
Dry mouth
Weight gain
Blurred vision
Decreased libido
Memory and attention issues
Involuntary body and/or facial movements

Anticonvulsants

Anticonvulsants are a type of medication that have been used since the mid-1990s to treat bipolar disorder. They’re prescribed either alone, with an antipsychotic drug, or in combination with antidepressants. They primarily work to control hypomania or mania by calming hyperactivity in the brain.

It’s not fully understood how anticonvulsants work to treat bipolar disorder, but it’s thought that with regulating various chemical changes and neuromodulation they are able to reset the abnormal electrical discharges occurring in the brain.

Types of anticonvulsants to treat bipolar disorder:

Depakote
Lamictal
Depakene
Tegretol
Topamax

Possible side effects of anticonvulsants to treat bipolar disorder:

Drowsiness
Weight gain
Increased inability to be calm and sit still
Increased risk of suicidal thoughts

Antidepressants

Antidepressants can be complicated when we’re looking at bipolar medication options. There’s widespread controversy about when (or if) they should even be used at all to treat bipolar disorder. Serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MAOIs), and tetracyclic antidepressants all might be prescribed to help manage depression symptoms in bipolar disorder.

However, antidepressants are also known to trigger manic episodes, so they most often would be prescribed in addition to an antipsychotic or mood stabilizer. The prescription and monitoring by an expert psychiatrist is needed in order to have a well regulated combination to address the complicated bipolar symptoms.

Types of SSRIs to treat bipolar disorder:

Types of SNRIs to treat bipolar disorder:

Pristiq
Cymbalta
Effexor
Fetzima

*Types of MAOIs to treat bipolar disorder:

Nardil
Parnate

Types of tetracyclic antidepressants to treat bipolar disorder:

Amitriptyline
Norpramin
Tofranil
Pamelor

Possible side effects of antidepressants to treat bipolar disorder:

Headache
Agitation
Nausea
Excessive sleepiness
Reduced libido

*NOTE: MAOIs are not often prescribed for bipolar disorder. The exception can be in cases where someone has had a less than optimal response to either SSRIs or SNRIs. Side effects of MAOIs might include sleep interference, reduced libido, increased appetite, gastrointestinal issues, dry mouth, or menstrual problems.

Benzodiazepines

Benzodiazepine is an anti-anxiety medication that can help with insomnia or anxiety. Although they are a fast-acting sedative, they can take several weeks to be fully effective. They’re also highly addictive, so caution should be used, especially if you have a substance abuse history. These are used in conjunction with major mood stabilizers to address the anxiety symptoms that can be complicating the bipolar presentation.

Benzodiazepines are central nervous system depressants that work by slowing brain activity to help you gain control of anxious thoughts and symptoms. They’re not usually the main treatment for manic episodes, but they can be taken for a short time period.

Types of benzodiazepines to treat bipolar disorder:

Xanax
Klonopin
Valium
Ativan

Possible side effects of benzodiazepines to treat bipolar disorder:

Lightheadedness
Dizziness
Drowsiness
Muscle weakness
Blurred vision
Fatigue
Slurred speech
Memory loss

Medications Commonly Prescribed for Bipolar Disorder

There are a wide variety of medications used to treat bipolar disorder. The following bipolar medication list can help you understand the different types of medications a provider might prescribe you.

Name Brand	Generic	Type	Description
Risperdal	Risperidone	Antipsychotic	Treats certain mood disorders like bipolar disorder, schizophrenia, and more.
Latuda	Lurasidone	Antipsychotic	A once-a-day bipolar medication that’s been proven effective for children, teens, and adults.
Vraylar	Cariprazine	Atypical antipsychotic	An atypical antipsychotic used to treat schizophrenia, bipolar mania, and bipolar depression.
Depakote	Valproic acid	Anticonvulsant	Can treat manic episodes associated with bipolar disorder.
Lamictal	Lamotrigine	Anticonvulsant	Prescribed for maintenance treatment of bipolar I disorder. More effective against depressive episodes than manic.
Topamax	Topirramate	Anticonvulsant	Works in the brain and is sometimes used to treat bipolar disorder.
Trileptal, Oxtellar XR	Oxcarbazepene	Anticonvulsant	Not approved by FDA to treat bipolar disorder, but might be an effective off-label treatment for manic episodes.
Celexa	Citalopram	SSRI – antidepressant	SSRI that improves energy levels and feelings of well-being.
Pristiq	Desvenlafaxine	SNRI – antidepressant	Not specifically approved to treat bipolar disorder, but prescribed off-label to treat manic episodes.
Norpramin	Desipramine	Tricyclics – antidepressant	Most often prescribed in conjunction with a mood stabilizer to reduce the chance of manic symptoms developing.
Nardil	Phenelzine	MAOIs – antidepressant	Not approved for use in treating bipolar, but sometimes prescribed with other medication.

Talk to your psychiatrist or healthcare professional about the possible risks and benefits associated with the above medications before starting treatment.

How to Get Bipolar Disorder Medication

Managing your bipolar disorder may mean multiple things. A combination of therapy and medication is often the most effective route. You should talk to your doctor if you’re thinking about starting bipolar meds or think they may be helpful.

Take the following steps if you’re looking for treatment with a bipolar disorder medication:

Get a diagnosisIn order to be diagnosed with bipolar disorder, you must have experienced at least one bipolar hypomanic or manic episode. Your doctor may perform a physical exam, order labs, and conduct interviews to make a diagnosis.
Begin therapy or treatment Therapy is instrumental in managing your bipolar disorder. It works in tandem with medication for the best results.
Understand your medication optionsLearn about the pros and cons of bipolar medication so you can decide with your mental health care provider what is best for your needs.
Talk to your prescriberYour prescriber can prescribe you the right medication and tailor a treatment plan. The first medication you try may not work or certain side effects may be more than you’re able to deal with. Your prescriber can have you try other medications if so and find the one best suited for you.

Should You Treat Bipolar Disorder with Medication?

Only you can make the decision about whether or not it’s time to begin medication to treat your bipolar disorder. The most important thing is talking to your provider and psychiatrist to help you decide and gather all the information you need.

Through your conversations, you’ll be able to learn more about the medications your prescriber might be considering. Then you can start to learn how each might affect you. You can also learn about other forms of treatment that you are able to pair with medication in order to get the best results.

Questions to ask your doctor:

Should I consider bipolar medications?Together with your provider, you should look at the pros and cons of any medication for bipolar disorder you’re thinking about taking.
What are possible side effects of this medication?It’s always important to understand the potential side effects of any medication. Not only can this help you decide which medication to try, but it can also help monitor how you’re feeling once you start something new. Knowing what to look for can help catch any potentially dangerous side effects before they become a serious problem.
What other treatments should I be considering for my bipolar disorder?There are a number of treatment options besides just taking medication for treating bipolar disorder. You might consider education, psychotherapy, self-management techniques, or even support groups.
Should I consider treatment in conjunction with bipolar medication? Cognitive behavioral therapy (CBT) has been found very effective in treating bipolar disorder. This type of therapy helps you identify and change negative thought patterns and behaviors that might be having a negative impact on your life. Talk therapy (psychotherapy) can also help you manage your bipolar disorder. By focusing on regulating your stress and making self-care a priority, you’ll be better able to manage a bipolar diagnosis.

Are there any holistic or self-help techniques I can try?Anytime you focus on taking care of yourself, your efforts are likely going to be worth the time you spend. That said, be careful about starting alternative treatments without the help of a doctor.Some people find that calming techniques, like meditation and yoga, for example, help them manage their stress, ultimately helping their bipolar disorder. While these things won’t cure bipolar disorder, they might help with your symptoms and be an integral part of your overall treatment plan.
Should I consider therapy in addition to medication?Most people find — and research shows — that a combination of medication and therapy offers the best outcome for managing bipolar disorder.
Are there any other conditions going on that could be contributing to bipolar disorder?Environmental factors like very stressful life events are likely triggers for new bipolar episodes. Other things that might increase your risk might include having a close relative who also has bipolar disorder. Traumatic events and other high-stress periods, as well as drug and alcohol abuse, are also thought to be potential contributors.

If you are interested in finding the right medication to treat bipolar disorder, connect with a prescriber at Talkspace today to learn more about online bipolar treatment.

Sources

About Dr. Muhammad Munir, MD

Dr. Muhammad Munir, MD, DFAPA, is a psychiatrist with over 26 years of clinical experience in various settings, with both child and adult psychiatry. His approach shifts the focus from the corporatization of healthcare to basic professional, ethical, and competent physician care. This greatly improves the dignity of a person who is struggling with emotional issues and seeking psychiatric care; a patient does better when they feel they’re being treated like a person and not as a number.Dr. Munir is passionate about improving the mental well being of his community and fights the stigma of mental health on various fronts.

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