Bipolar disorder, also known as manic depression, is a severe mental disorder that causes extreme shifts in mood and can severely affect the ability to carry out day-to-day tasks. First signs of bipolar disorder usually emerge during the late teens or early adult years. However, it has been diagnosed in young children and in later life. People with bipolar disorder experience extreme highs (mania) and lows (depression). Mania is characterized by extreme changes in energy, a decreased need for sleep and extreme excitability. Mania is usually followed by extreme depression. There is no cure for bipolar disorder, but medications, therapy and in some cases electroconvulsive therapy can all help manage symptoms.
Lithium
Lithium is a commonly prescribed medication for bipolar disorder. Doctors aren't sure how lithium works, but it has proved to be effective for mood stabilization and reducing suicide. When taking lithium, it's important to have blood drawn regularly to check the lithium level to make sure it's not too high or too low. A low level isn't therapeutic, and higher levels may be toxic. Minor side effects of lithium include weakness, lack of coordination, nausea, vomiting and itching. Severe side effects that require immediate medical attention include extreme thirst, feeling light-headed, fainting, slow heart rate, seizures, hallucinations and fever.
Anticonvulsants
Anticonvulsants are usually prescribed for people with epilepsy but are now commonly used as a mood stabilizer in people with bipolar disorder to even out the highs (mania) and the lows (depression). Medications such as Depakote, Keppra, Lamictal, Trileptal, Topomax and Tegretal decrease the amount of activity in the brain. When the nerve cells of the brain are less excitable, mania and depression are less likely to occur. Side effects of anticonvulsants include tremor, dizziness, fatigue, rash, nausea and weight gain.
Benzodiazepines
Xanax, Klonopin, Valium, Ativan and Librium reduce the amount of activity in the brain. Mood stabilizers can take days to weeks to take effect, and benzodiazepines are given to quickly control certain symptoms of mania. Benzodiazepines act within 15 to 20 minutes when taken orally and can cause drowsiness, dizziness, memory loss and fatigue. Benzodiazepines are usually prescribed for short periods because of their addiction potential. Benzodiazepines should never be stopped abruptly and should be tapered slowly to avoid seizures.
Antipychotics
Antipsychotic medications help balance neurotransmitters in the brain. The exact mechanism of how they work is not known, but they are prescribed short-term during manic episodes accompanied by psychosis. The newer antipsychotics, Zyprexa, Risperdal, Abilify and Seroquel, can be prescribed alone because they have mood-stabilizing properties and reduce the impulsiveness and reckless behaviors associated with mania. Other antipsychotics include Clozaril, Haldol and Thorazine. Side effects can be difficult to deal with and include rapid weight gain, an increased risk of diabetes, muscle spasms and dry mouth. An irreversible condition called Tardive Dyskensia, characterized by involuntary lip smacking, protruding of the tongue and facial grimacing, can occur with long-term antipsychotic use.
