Bipolar disorder is a neurochemical problem in the brain that can affect a person's mood stability and ability to function. Otherwise known as manic depression, bipolar disorder symptoms can make it difficult or impossible to function in relationships and at school or work. In addition to psychotherapy, a physician-supervised medication regimen is generally recommended to manage bipolar symptoms. Although there is no known cure for the disorder, medications can help an afflicted person lead a healthy and productive professional and personal life. In the U.S., about 5.7 million adults suffer from the effects of bipolar disorder in any given year.
Medical Providers Who Prescribe Medications
Medications to treat the symptoms of bipolar disorder can be prescribed by a physician, usually a psychiatrist who is a physician specialist in mental health and disorders. The prescribing physician can also be a general or family practitioner. Clinical psychologists with specific training for prescribing medications and psychiatric nurse practitioners can also treat bipolar disorder.
Classifications of Bipolar Diagnostic Types
The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR, American Psychiatric Association, 2000) distinguishes between six types of bipolar disorder and symptoms. Each is described and separated by the occurrence of manic, hypomanic or depressive symptoms; the most recent occurrence of these symptoms; and whether there have been previous episodes of acute symptoms.
Classifications of Bipolar Disorder Medications
Many of the medications used to treat bipolar disorder are taken in concert and over one's lifetime. Each type targets a different subset of symptoms of the disorder. The U.S. National Institute of Mental Health (NIMH) identifies antidepressant, antipsychotic and mood stabilizing medications as the three most common medications used to mitigate the effects of bipolar symptoms. How and when each is prescribed depends upon the type of bipolar disorder present and the associated symptoms.
Mood Stabilizing Medications
Mood stabilizing medications are oftenanti-convulsant medications that have been found to also treat symptoms of bipolar disorder. This class of medications is generally prescribed as a first trial when a person is newly diagnosed with the disorder. They are meant to control the extreme highs and lows of mood fluctuation experienced by a person with the disorder. Examples of this type of medication are lithium (Eskalith), valproic acid or divalproex sodium (Depakote), lamotrigine (Lamictal) and topiramate (Topamax).
Antidepressant Medications
Medications such as fluoxetine (Prozac) and sertraline (Zoloft) are often taken along with mood stabilizing medications to offset the depressive symptoms of bipolar disorder. These symptoms include depressed mood, weight loss/gain, difficulty concentrating, sleep disturbances (too much or too little), fatigue and loss of energy, ideas of suicide and preoccupation with death. Other medications in this class include paroxetine (Paxil), bupropion (Wellbutrin) and escitalopram oxalate (Lexapro).
Antipsychotic Medications
Also referred to as "atypical antipsychotic medications," these are used to manage the psychotic symptoms of bipolar disorder. These medications include olanzapine (Zyprexa), apripiprazole (Abilify) and risperidone (Risperdal). Bipolar psychotic symptoms include hallucinations, delusions of grandeur, confusion, rapid speech and an inability to recognize behavior and symptoms as abnormal or dangerous.
References
- American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th ed, text revision. Washington, DC: American Psychiatric Assocation
- U.S. National Institure of Mental Health - Bipolar Information
