According to the American Psychiatric Association, bipolar disorders affect approximately 1.6 percent of the population. Currently, bipolar disorders include bipolar I and bipolar II. Previously, these were not differentiated and this disorder was known as manic depression. Typically, mood stabilizing medication is used to treat bipolar disorders. When a single medication proves ineffective at controlling all symptoms, however, combinations of medications that include mood stabilizers, antidepressants and antipsychotics have been shown to be effective.
Mood Stabilizers
Mood stabilizers are the predominate medication used to treat bipolar disorders. According to the Clinical Handbook of Psychotropic Drugs, mood stabilizers typically fall into one of three chemical classes: lithium, anticonvulsant and tryptophan. The commercial names of lithium-based mood stabilizers that are prescribed in the United States include Lithotabs, Eskalith, Lithonate, Lithobid and Cibalith-S, which is a liquid form of the medication. Klonopin, Dilantin, Tegretol, Depakote and Topamax are a few of the medications that fall under the anticonvulsant class. Tryptan, which falls into the tryptophan class, is typically used as an adjunct to other medications, but has been shown to have some efficacy when used alone.
Antidepressants
According to the article, "The Expert Consensus Guideline Series: Medication Treatment of Bipolar Disorder," bipolar patients who suffer from more severe episodes of depression may benefit from the addition of bupropion, a selective serotonin reuptake inhibitor (SSRI), or venlafaxine to lithium, or extended-release depakote (divalproex) treatment. In patients who rapidly cycle between manic and depressed symptoms, divalproex has been shown to be an effective initial treatment even without the adjunct of an antidepressant.
Antipsychotics and Other Treatments
Atypical antipsychotics, especially olanzapine and risperidone, are helpful as an adjunct to a mood stabilizer as well. These are most helpful in patients who experience psychotic episodes during manic or depressive stages of bipolar. In patients with symptoms that are particularly hard to treat, clozapine and thyroid treatments can be successful. Electro-convulsive therapy (ECT), which is a non-pharmaceutical treatment, has also shown some success in alleviating treatment resistant symptoms.
References
- "Clinical Handbook of Psychotropic Drugs"; Mood Stabilizers; Bezchlibnyk-Butler and Jeffries (Eds.); 2005
- Diagnostic and Statistical Manual, 4th edition Text Revision; American Psychiatric Association; 2000
- "Postgraduate Medicine"; The Expert Consensus Guideline Series: Medication Treatment of Bipolar Disorder 2000; Sachs et al., April, 2000.
