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What Is The Best Medication For Bipolar Disorder

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What Are The Symptoms Of Bipolar Disorder

What is the Best Treatment for Bipolar Disorder?

Bipolar disorder is a brain neurobiological disorder that affects nearly 1% of the population. People diagnosed with this condition have mood swings that alternate between periods of severe highs and extreme lows . Suicide is the leading cause of premature death in people with bipolar disorder, with 15 to 17% of people committing suicide due to negative symptoms resulting from untreated illness. Other symptoms depend on mood swings.

During a manic high, people may experience:

  • Very happy, energetic or on edge
  • Like they need very little sleep
  • Too sure of oneself
  • Like spending a lot of money or getting involved in dangerous activities

After a manic episode, they may return to normal and then experience a change in mood in the opposite direction of a depressive episode. During a depression, people may have:

  • Difficulty thinking and making decisions
  • Memory problems
  • Less interest in things they enjoyed in the past
  • Thoughts of committing suicide

There is no secret formula for managing bipolar disorder, but there are many treatment options available depending on your goals.

The Most Effective Therapies For Treating Bipolar Disorder

Youve been diagnosed with bipolar disorder, or maybe your loved one has. And youre wondering, whats the best treatment? What actually works? What the heck do I do?

Because bipolar disorder is a chronic, complex condition, managing it can feel overwhelming and downright confusing. But thankfully there are effective, research-based treatments that really work.

Medication is the mainstay of treatment. However, the best way to treat bipolar disorder is with a comprehensive approach, which includes ongoing psychosocial interventions to help maintain health and to respond to breakthrough symptoms when they occur, according to Candida Fink, MD, a board-certified child, adolescent, and adult psychiatrist with a private practice in Westchester, N.Y.

She noted that bipolar disorder is often thought of as a kind of monolithic entity. But bipolar disorder comes in a range of severity and symptom patterns. Different people will respond to different treatmentsboth medical and psychosocial.

Finding the right treatment for each person takes time, consistent effort, and good communication with their treatment team, said Dr. Fink, co-author of several books on bipolar disorder.

Below, youll learn about these treatments, along with how you can get help and what strategies you can try on your own.

Tricyclic Antidepressants For Bipolar Disorder

Older tricyclic antidepressants used for treating bipolar disorder may be more likely to trigger a manic episode or rapid cycling than other depression drugs. They also tend to have more side effects than newer generation antidepressants, and can be especially dangerous in overdose. Nowadays, tricyclic antidepressants are often prescribed for conditions other than depression, such as neuropathic pain, migraine headaches, insomnia, or irritable bowel syndrome.

Like all antidepressants, experts recommend against taking a tricyclic medication without a mood stabilizer in bipolar I disorder, in order to minimize the chance of inducing mania symptoms.

Tricyclic antidepressants include:

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Psychotherapy For Bipolar Disorder In Children

Different types of psychotherapy have also been shown to be useful in childhood bipolar disorder treatment. These are often used alongside medication treatment. Therapies that appear to be useful include:

  • Social rhythm therapy
  • Family therapy
  • Group therapy

Because childhood bipolar disorder affects the whole family, family therapy should always be a priority both for the sake of the child with bipolar and also the family.

Inpatient Bipolar Child Treatment

Managing bipolar disorder: pharmacologic options for ...

An emergency situation is commonly when medical help is sought and inpatient help may be needed to assess and diagnose a child for the childs and the familys safety. Inpatient treatment for a child with bipolar disorder is also typically required in situations when the child is acutely suicidal, homicidal or psychotic.

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Top Mood Stabilizers For Bipolar Disorder

None of them are perfect, but a few rise to the top, according to recent guidelines.


Ive been pouring over textbooks and treatment guidelines, and these four mood stabilizers keep rising to the top.1-6 None of them are perfect, but each has a unique role in bipolar disorder:

  • Lithium
  • Lurasidone
  • Lamotrigine

Lithium and quetiapine top the lists for all three phases of the illness: mania, depression, and the maintenance phase. Lurasidone and lamotrigine are either untested or ineffective in mania, but they are essential tools for bipolar depression.


Lithium stands out for its preventative effects in bipolar disorder, but it also has important benefits outside of the manic-depressive symptom lists. It is the only mood stabilizer that significantly reduces the risk of suicide, and it reduces mortality in other ways as well. Although lithium is often avoided out of concerns of toxicity, it actually lowers the risk of cancer, heart disease, stroke, and viral illnesses.7 All of those occur at higher frequency in bipolar disorder. Vascular disease is the leading cause of death in bipolar disorder,8 and viral illnesses are both a consequence and cause of bipolar symptoms.9


Lurasidone and Lamotrigine

The Bottom Line

For related content, see Dosing Secrets for the Top Mood Stabilizers.


Interpersonal And Social Rhythm Therapy

In Interpersonal and Social Rhythm Therapy , patients first learn to recognize the relationship between their circadian rhythms and daily routines, as well as their mental health symptoms. IPSRT then focuses on stabilizing sleep/wake cycles, maintaining regular patterns of daily activities , and addressing potential problems that may disrupt these routines.

This often involves resolving current interpersonal problems and developing strategies to prevent such problems from recurring in the future. When combined with medication, IPSRT can help individuals increase their targeted lifestyle routines and reduce both depressive and manic symptoms.

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Is It Bipolar Disorder Or Depression

Bipolar disorder is commonly misdiagnosed as depression since most people with bipolar disorder seek help when theyre in the depressive stage of the illness. When theyre in the manic stage, they dont recognize the problem. Whats more, most people with bipolar disorder are depressed a much greater percentage of the time than they are manic or hypomanic.

Being misdiagnosed with depression is a potentially dangerous problem because the treatment for bipolar depression is different than for regular depression. In fact, antidepressants can actually make bipolar disorder worse. So its important to see a mood disorder specialist who can help you figure out whats really going on.

Do I have depression or bipolar disorder?

Indicators that your depression is really bipolar disorder include:

  • Youve experienced repeated episodes of major depression.
  • You had your first episode of major depression before age 25.
  • You have a first-degree relative with bipolar disorder.
  • When youre not depressed, your mood and energy levels are higher than most peoples.
  • When youre depressed, you oversleep and overeat.
  • Your episodes of major depression are short
  • Youve lost contact with reality while depressed.
  • Youve had postpartum depression before.
  • Youve developed mania or hypomania while taking an antidepressant.
  • Your antidepressant stopped working after several months.

What Is Bipolar Depression

What medications work best for bipolar?

Bipolar depression, or bipolar disorder , is a mental health condition that causes extreme mood swings such as emotional highs and lows .

When individuals become depressed, they may feel sad or hopeless and lose interest or pleasure in most activities. When their mood shifts to mania or hypomania, they may feel euphoric, full of energy, or unusually irritable. These mood swings can affect sleep, energy, activity, judgment, behavior, and the ability to think clearly.

There are three types of bipolar disorder. All three types involve evident changes in mood, energy, and activity levels.

  • Bipolar I disorder defined by manic episodes that last at least seven days or by severe manic symptoms that require immediate hospital care. Typically, depressive episodes occur as well
  • Bipolar II disorder defined by a pattern of depressive episodes and hypomanic episodes but not the full-blown manic episodes that are typical of Bipolar I disorder
  • Cyclothymic disorder defined by periods of hypomanic symptoms as well as periods of depressive symptoms lasting for at least two years

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Where Do I Start

;If you think you might have bipolar disorder or are unhappy with your medication, talk to your doctor as soon as you can. Write down a list of questions, and dont be afraid to share your concerns about side effects or past experiences. If youre currently experiencing a manic or depressive episode, you may need to consult with your doctor at least once a week to assess the effects of the medication. If you are feeling suicidal or experiencing psychotic symptoms, you can go to the hospital or call a loved one for help. You can also call the National Suicide Prevention Lifeline at 1-800-273-TALK or their TTY number at 1-800-799-4TTY .

The more information you give your doctor, the better they can help you find the right treatment for your bipolar disorder. What steps can you take today to take the best care of your mind, mood, and body?

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  • Stages & Symptoms Of Bipolar Disorder

    There are mainly 4 times of bipolar disorder:

    • Mood episodes: These are a feature of bipolar disorder and are the first stages of sadness and mania, but there are also additional stages. Its critical to understand the symptoms of each stage so that your Mercy provider can give the appropriate therapy.
    • Continuation and maintenance phase: Following a bipolar mood episodes remission, youll most likely require maintenance treatment to delay or avoid future episodes. Medication and psychotherapy are part of the standard maintenance treatment.
    • Mixed and mood state: Symptoms of both manic and depressive moods are present in a mixed mood state. Periods of low mood, fueled by impulsive overactivity and poor judgement, might increase the risk of self-harm or aggression towards others.
    • Acute Mania: Acute mania is characterised by a heightened sense of energy or irritability, as well as increased activity. Exaggerated self-esteem, a decreased need for sleep, racing thoughts, excessive distractibility, and episodes of reckless conduct such as spending binges, sexual activity, and drug use are all possible signs.
    • Acute Major Depressive Episodes: During a two-week period, involves five or more of the following symptoms for most of the day or almost every day:
  • Sadness, desolation, or despair are all words that come to mind when one thinks of sadness, desolation,
  • Exhaustion and a lack of energy are two of the most common symptoms of exhaustion.
  • Suicide or death thoughts on a regular basis
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    What Are The Best Medications Treatments For Bipolar Depression

    The best medications for bipolar depression are those that decrease symptoms of depression without inducing a manic or hypomanic episode. These medications can improve depression while keeping moods stable. Non-pharmaceutical treatments for bipolar depression have the same goals in mind, but additionally, they help people deal with the challenges, frustrations, and limitations of the disorder while developing coping skills to live well despite episodes of bipolar depression.

    Bipolar depression treatment is usually a long-term approach. Mood stabilization, symptom reduction, and the development of coping strategies is best done with a combination of medication and psychotherapy.

    Medication and psychotherapy are the primary approaches to treat bipolar depression; however, other treatments exist that can augment medication and therapy. These include complementary treatments like light therapy, brain stimulation procedures, peer support, and lifestyle changes.

    Given the importance of medication in treating bipolar depression, lets look at some of the best medications, some which you or a loved one might be prescribed.

    + Happy & Healed Bipolar Disorder Patients

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    Hi, I am a 35 years old woman working in an MNC. Ive had bipolar disorder type I for the past three years and was just diagnosed. I have observed that Ive lost weight and that Im not sleeping properly. I sympathise with anyone who is suffering from mental illness, especially if their family or friends do not understand. I continue to accept and live with what is every day. Im working on my balance and have a wonderful support system that is Mantra Care. I am able to deal with my anger issues well.

    Kevin,1 year on MantraCare

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    Treatment For Bipolar Disorder:

    Before we dive into the treatment, it is important to know that the cause behind it is still unknown. The doctor having specialization in treating patients with mental conditions can only provide the best treatment. In most cases, psychologists, psychiatric nurses, and social workers are also included in the treatment. It is a lifelong condition, so a person cannot avoid it.

    The Atypical Antipsychotics Are The Evidence

    Dr. Ellen Leibenluft

    In terms of treating bipolar disorder in children, the bulk of the evidence that we have is for medications called atypical antipsychotics, including risperidone, seroquel, aripiprazole, olanzapine, and others. And there are a number of such medications where there have been good studies, so-called double-blind, placebo-controlled studies, which show that these medications work, particularly for mania. Almost all of the trials focus on the manic side, and indeed some of these medications do have FDA indications for use in children, for mania.

    Other medications that are used are the so-called mood stabilizers, such as lithium and valproate. There is some evidence that children with bipolar disorder may be somewhat less likely to respond to those medications than do the adults with bipolar disorder, although this is an area that certainly needs a lot more work.

    One problem of course is that all of these medications have side effects, and the atypical antipsychotic medications in particular are often associated with weight gain and with children beginning to have difficulty with their so-called lipid profiles, this is called the metabolic syndrome, and we are concerned about long-term consequences. So youre always balancing whats effective versus the side-effect profile, trying to get as much effectiveness as you can and as few side effects as you can, and its really a very individualized kind of decision.

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    Water Pills Interacts With Lithium

    Taking lithium with some “water pills” can increase the amount of lithium in the body. This can cause serious side effects. Talk to your healthcare provider if you are taking lithium before taking “water pills.” Some types of “water pills” include chlorothiazide , hydrochlorothiazide , indapamide , metolazone , and chlorthalidone .

    Psychosocial Interventions For Alcohol And Substance Use Disorders

    What is the Best Bipolar Treatment?

    Many individuals with bipolar disorder also struggle with an alcohol or substance use disorder. Co-occurring disorders are best treated concurrently, meaning that treatment for bipolar disorder should be integrated with the treatment for the alcohol or drug problem.

    Integrated treatment includes motivational enhancement and cognitive-behavioral interventions. Integrated treatments are effective at reducing substance use, preventing relapse, and keeping individuals in treatment longer. These interventions can be delivered one-on-one or in a group format.

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    Causes And Risk Factors

    Although the origins of bipolar disorder are still unknown, there are several underlying causes and risk factors that increase the likelihood of developing this disorder. Heredity appears to be one of the primary factors involved. According to the Depression and Bipolar Support Alliance, approximately two-thirds of individuals with bipolar disorder have one or more family member who also has a severe mood disorder.

    Neurological factors also play a significant role in mood disorders like bipolar disorder. Brain chemicals called neurotransmitters, such as dopamine, norepinephrine, and serotonin, play critical roles in moods and energy levels. In people with bipolar disorder, these chemicals may be deficient or imbalanced, contributing to the severe emotional fluctuations and energy states. Hormonal imbalances and structural changes in the areas of the brain responsible for cognition and mood regulation have also been associated with bipolar disorder, according to Frontiers in Psychiatry. Current research indicates that there is no single neurobiological factor involved in bipolar disorder, but that there are several different pathologies that may trigger bipolar symptoms.

    An individuals environment can be a risk factor for developing bipolar disorder.

    Children who grow up in stressful or abusive home environments may have a higher risk of developing mood disorders in adolescence or young adulthood, when the symptoms of bipolar disorder first manifest themselves.

    Nsaids Interacts With Lithium

    NSAIDs are anti-inflammatory medications used for decreasing pain and swelling. NSAIDs might increase lithium levels in the body. Taking lithium along with NSAIDs might increase the risk of lithium side effects. Avoid taking lithium supplements and NSAIDs at the same time. Some NSAIDs include ibuprofen , indomethacin , naproxen , piroxicam , aspirin, and others.

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    Psychosocial Interventions For Weight Management

    Weight gain is a significant and frustrating side effects of some medications used to treat the symptoms of bipolar disorder. Weight gain can lead to problems such as diabetes and hypertension, making it a serious health issue for many individuals.

    Resources to support weight loss are available. Weight programs generally last 3 months or longer and include education about nutrition and portion control. Participants learn skills to monitor their daily food intake and activity levels, have regular weigh-ins, and set realistic and attainable personal wellness goals.

    Participation in such a program can help prevent additional weight gain and lead to modest weight loss. The VAs version of this program is called MOVE! It is offered in a supportive group setting.

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    How Common Is Bipolar Disorder In People With Adhd

    Drugs to Treat Bipolar Disorders

    In a , researchers sought to examine the prevalence of bipolar disorder in a group of 2.4 million people born in Denmark between 1955 and 1991.

    They looked at bipolar disorder in people diagnosed with ADHD, an anxiety disorder, both, or neither.

    The researchers found that bipolar disorder was almost 11 times more likely in people with a prior diagnosis of ADHD, compared with people who had no prior diagnosis of ADHD or anxiety.

    The incidence rate of bipolar disorder was 30 times higher in people with a prior diagnosis of ADHD and anxiety than people who werent diagnosed with either.

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