Bipolar disorder is a serious mood disorder. Everyone goes through normal ups and downs in life, sometimes feeling happy and sometimes feeling sad. People with bipolar disorder, however, have moods that swing to extremes--their depression is not mere sadness; it fuels feelings of hopelessness and thoughts of suicide. Their mania is not just happiness; it can affect their financial life, work and interpersonal relationships.
There is good news for the Americans who have bipolar disorder. Medications can help stabilize mood swings.
Mood Stabilizers
Lithium was found to help stabilize the moods of people with bipolar disorder in the 1950s. It is still used today and has been found to work best in people whose bipolar diagnosis occurs at an early age, who have a family history of bipolar and whose extreme mood swings are balanced with periods of more normal moods.
In 1995, the anticonvulsant divalproex sodium (Depakote) was approved by the FDA to treat bipolar disorder. The drug was found to work better than lithium for people who rapidly swing from depression to mania (rapid cycling) and in people whose mania is "tinged" with depression (mixed state or dysphoric mania). The anticonvulsant was also found to work better in people who had substance abuse problems in addition to bipolar disorder.
Other anticonvulsants used as mood stabilizers include carbamazepine (Tegretol), lamotrigine (Lamictal) and oxcarbazepine (Trileptal).
Antidepressants
Antidepressants are commonly prescribed for bipolar depression and may be used in conjunction with mood stabilizers. There is some controversy surrounding the use of antidepressants in bipolar disorder because of the risk of "switching" to mania, but data from large National Institute of Mental Health-funded studies, such as the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD), do not show this to be true.
This does not hold true for everyone. A 2006 study by the Stanley Foundation found that people with bipolar depression who were given venlafaxine (Effexor) had a higher risk of rapid switching to mania than people who were prescribed bupropion (Wellbutrin) or sertraline (Zoloft).
Other antidepressants prescribed for bipolar depression include duloxetine (Cymbalta), fluoxetine (Prozac) and citalopram (Celexa).
Atypical Antipsychotics
Antipsychotics were first prescribed to treat schizoprehenia, but they have been found to help people with bipolar disorder as well. Atypical antipsychotics are different from "typical" antipsychotics because they do not cause permanent motor dysfunction commonly associated with the latter. For this reason, they are preferable for people with bipolar disorder to help treat mania. They may be combined with mood stabilizers and antidepressants.
Some atypical antipsychotics prescribed for bipolar disorder include quetiapine fumarate (Seroquel), olanzapine (Zyprexa), aripiprazole (Abilify), risperidone (Risperdal) and ziprasidone (Geodon).
Atypical antipsychotics may cause weight again and have been found to increase the risk of diabetes in some people.
References
- National Institute of Mental Health: Medications to Treat Bipolar Disorder
- National Alliance on Mental Illness: Understanding Bipolar Disorder and Recovery
- American Journal of Psychiatry; Risk of Switch in Mood Polarity to Hypomania or Mania in Patients with Bipolar Depression During Acute and Continuation Trials of Venlafaxine, Sertraline, and Bupropion as Adjuncts to Mood Stabilizer; G. Leverich, L. Altshuer and M. Frye; 2006
