Bipolar disorder is treated with three categories of drugs – mood stabilizers, atypical antipsychotic drugs and antidepressants. Mood stabilizers are the first line treatment for this mental disorder. Lithium is one of the first drugs used for healing mania and depression, the two primary symptoms of bipolar disorder. Anticonvulsant drugs, primarily used for treating seizures, are widely recommended for bipolar disorder patients to stabilize mood. To prevent recurrence, sometimes psychiatrists prescribe antipsychotic medications. The depressive episodes often respond to antidepressants.
Bipolar Disorder Drugs
Lithium
Lithium is the most effective drug for reducing mania and depression associated with bipolar disorder. Prolonged intake of lithium can prevent future episodes of bipolar disorder. Risk of suicide in people diagnosed with bipolar disorder can be reduced significantly with the help of this mood stabilization medication. The positive effect of the lithium is noticeable one to two weeks after taking the drug. Lithium is used in maintenance treatment to prevent remission of the mental illness.
Discontinuation of this medication even if the symptoms had not occurred for several months increases the risk of relapse. Usually psychiatrists recommend lower doses of the drug for long-term use. However, prolonged use of this mood stabilizer can impair thyroid and kidney functions.
The adverse effect of lithium can be reduced by consuming sufficient amount of water and retaining normal sodium consumption during the treatment. Hand tremor, poor memory, weight gain, diarrhea, vomiting, excess thirst, increased urination, muscle weakness, drowsiness, acne and hair loss are common side effects of the drug.
Anticonvulsants
Anticonvulsants are prescribed either alone or with other bipolar disorder drugs for improving the mood of patients. These drugs help to reduce the hyperactivity of the brain. It is usually prescribed to stabilize the mood of people who experience at least four episodes of mania and depression every year. Anticonvulsants commonly used for bipolar disorder treatment include lamotrigine, oxcarbazepine, carbamazepine, topiramate, tiagabine and divalproex sodium.
To realize the benefits of these drugs, they should be taken for several weeks. Common side effects of anticonvulsant intake include fatigue, drowsiness, dizziness, nausea, rash, weight gain and tremor. Kidney and liver damage and reduced platelet counts are linked to some anticonvulsant drugs. The risk of adverse side effects can be avoided through routine blood tests and regular medical supervision.
Antipsychotic Drugs
Antipsychotic drugs such as aripiprazole, asenapine, clozapine, olanzapine, quetiapine, risperidone and ziprasidone are recommended for healing delusions and hallucinations that might occur during the episodes of severe depression and acute mania. By acting on the neurotransmitters of the brain, these drugs help to stabilize the mood.
Although conventionally used for short-term treatment, some of the recent antipsychotic drugs are recommended for long-term use especially when lithium and anticonvulsants fail to produce the desired result. Weight gain, high cholesterol level, dry mouth, blurred vision, drowsiness and tremors are common side effects of these drugs.
Calcium Channel Blockers
Calcium channel blockers, traditionally used for lowering the blood pressure level, can be effective in reducing the symptoms of bipolar disorder. However, these medications are not as popular as the aforementioned drugs in treating bipolar disorder. Headache, irregular heart rhythm, low blood pressure, swelling of the legs, constipation and fatigue are common side effects of this medication.
Benzodiazepine
By slowing down the hyperactivity of the brain, benzodiazepines rapidly heals the maniac episodes of bipolar disorder. They are used for short-term treatment, usually along with conventional mood stabilization drugs.
Benzodiazepines used for treating this mental disorder include alprazolam, clonazepam, diazepam and lorazepam. Side effects that might occur following intake of benzodiazepines include blurred vision, dizziness, fatigue, memory loss, slurred speech and muscle weakness. Benzodiazepines can be addictive if taken for a prolonged period.
Antidepressants
The depressive episodes of bipolar disorder can be alleviated with antidepressants. Selective serotonin reuptake inhibitors (SSRI) are widely used for treating depression. By boosting the level of the neurotransmitter serotonin in the brain, SSRIs help to improve the mood. The SSRI paroxetine is widely recommended for treating depression.
Most people respond to this antidepressant. Other SSRIs prescribed by psychiatrists include citalopram, escitalopram, fluoxetine, fluozamine, and sertraline. Headache, nervousness, diarrhea, agitation, low sex drive, sleeping difficulties, change in weight, rash are some of the side effects of SSRIs. Rarely monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants are used for treating depression in bipolar disorder patients. However, antidepressants may increase the risk of suicides.
Hence, patients on these drugs need to be monitored closely especially at the early stage of the treatment or when the dose of the drug is changed. As the antidepressants provide fast relief from depression, if taken without other conventional bipolar disorder drugs may worsen the mania episodes, thereby increasing the recurrence of the maniac-depressive symptoms of the illness.
