Types Of Mood Stabilizers For Bipolar Treatment
Bipolar disorder is different in different people, and a;treatment that can help someone else may not work for you, and vice versa.
But in general, mood stabilizers should always be used along with antidepressants to treat bipolar disorder in order to reduce the risk for mania, according to a 2014 study published in the American Journal of Psychiatry.
Mood-stabilizing medications that your doctor may recommend include:
Lithium. This drug can help balance out the emotional highs and lows of bipolar disorder.
“Lithium has this curious property of working both against mania and depression,” says Gary Sachs, MD, founding director of the Bipolar Clinic and Research Program at Massachusetts General Hospital in Boston and associate clinical professor of psychiatry at Harvard Medical School.
Lithium appears to work by helping to normalize brain activity. It also helps prevent both depression and mania relapses.
Valproate and carbamazepine. Valproate and carbamazepine were first used to treat convulsions in people with epilepsy.
Researchers then found that these drugs could also help treat bipolar disorder symptoms. “Valproic acid and carbamazepine have, in fact, been shown to be efficacious for the treatment of acute mania,” says Dr. Sachs.
The two drugs work by calming the brain, resulting in a better and more stable mood.
Sachs says there is also evidence supporting the use of valproate to help prevent recurrences of bipolar episodes.
What Are Potential Side Effects Of Bipolar Medications
Common side effects of these drugs may include:
- Sexual problems
Its imperative to work with your doctor or psychiatrist to manage your drug therapy. Because bipolar disorder symptoms vary greatly from person to person, it can take time to identify the best medication to manage your symptoms. Sometimes, you may need to try a few medications or combinations of medications before finding the right one.
Side Effects Of Mood Stabilizers
Depending on the medication you are using, your doctor or pharmacist can tell you about side effects you could experience.
In general, lithium is commonly associated with:
- Liver problems
Any doctor can prescribe these medications, but it’s a good idea to see a psychiatrist, who’s trained to deal with mental illnesses such as bipolar disorder.
You will probably take these medications over the long term, and you may need to add medications if you have manic or depressive episodes that break through despite the treatment.
People with bipolar disorder usually need more than one medication. Over time, working with your psychiatrist, you can determine which bipolar treatment regimen works best for you.
What About Side Effects Of Medications For Bipolar Disorder
A list of common bipolar medication side-effects, why some are so serious, and a mood and medication side-effects chart for you to use.
Gold Standard for Treating Bipolar Disorder
Side effects are the number one reason people with bipolar disorder stop taking their medications. And for many, one bad experience leads to the idea that no medication will be helpful. This is an unfortunate decision, as many side-effects can either lessen over time or be managed with medication dosage changes, adding a new drug or switching to a drug that you are more able to tolerate. Because people with bipolar disorder usually take more than one medication, it’s important that side-effects be monitored and taken seriously by a healthcare professional. The goal is to find a balance between the efficacy of the medication and its potential side-effects.
Common Bipolar Medication Side-effects
- Increased appetite and weight gain
- Lack of appetite and weight loss
- Sexual side effects
- Waking up too early and unable to go back to sleep
- Blurred vision
- Suicidal thoughts
It must be said that there are some side-effects that are intolerable such as suicidal thoughts or excessive weight gain. This is when contacting your healthcare professional is essential. You can then work together to find a medication that you are better able to tolerate.
How Can You Treat Bipolar Depression Effectively
One of the challenges facing clinical psychiatry is how to treat bipolar depression effectively. Surprisingly, its neurobiology and rational decisions about its treatment remain somewhat of a mystery. Recent findings have even called into question the role of traditional antidepressants in bipolar depression when other classes of drugs may be more effective first-line treatments for this illness.
Since finding the right drug and dose can be tricky, its important to work closely with a specialist and re-evaluate your medication regularly. Its also important to remember that taking medication is just one aspect of a successful treatment program. There are plenty of other steps you can take to manage your symptoms and even reduce the amount of medication required. Healthy lifestyle changes, self-help coping strategies, and exploring therapy are also important in coping with bipolar disorder symptoms and helping you live a full, productive life.
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Which Bipolar Medicine Is Best
The best bipolar medicine is the one that works best for you. Work with your doctor to decide on the medication plan that helps you the most.
You may keep taking these medications for years or decades, even if itâs been a long time since your last manic or depressive episode. This is called maintenance therapy and helps prevent recurrence of symptoms.
Questions To Ask Your Doctor
- When and how frequently will I need to take this medication?
- What are the side effects, and how can I manage them?
- How long should I take the medication before we know whether its working for me?
- Will any foods, other medications, or medical conditions interact with this medication?
- Will this medication cause withdrawal if I decide to stop taking it? If so, how could I manage that?
- Can you recommend self-treatment options that can provide additional support ?
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Can I Drive When Taking Mood Stabilisers
Some mood stabilisers may make you drowsy and affect your driving. Tell the DVLA if you are taking medication that may affect your driving. You should also tell them if you have a medical condition that could affect your driving.
You can find out more about Driving and mental illness by clicking here.
Medications For Depression Interacts With Lithium
Lithium increases a brain chemical called serotonin. Some medications for depression also increase the brain chemical serotonin. Taking lithium along with these medications for depression might increase serotonin too much and cause serious side effects including heart problems, shivering, and anxiety. Do not take lithium if you are taking medications for depression. Some of these medications for depression include fluoxetine , paroxetine , sertraline , amitriptyline , clomipramine , imipramine , and others.
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What Is Bipolar Depression
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
What Are The Possible Side Effects Of Anti
Like other medications, anti-anxiety medications may cause side effects. Some of these side effects and risks are serious. The most common side effects for benzodiazepines are drowsiness and dizziness. Other possible side effects include:
- Trouble sleeping
Anti-anxiety medications may cause other side effects that are not included in the lists above. To report any serious adverse effects associated with the use of these medicines, please contact the FDA MedWatch program using the contact information at the bottom of this page. For more information about the risks and side effects for each medication, please see
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Fluoxetine Is The Only Antidepressant To Be Used In Bipolar Disorder Nice Says
NICE is now focusing on the effectiveness of individual drugs, rather than the tradition of recommending drug classes as a whole for its bipolar guidance.
Fluoxetine is the only antidepressant that is effective in treating bipolar depression, and only in combination with the atypical antipsychotic olanzapine, says an updated clinical guideline;published by the National Institute for Health and Care Excellence on 24 September 2014.
This marks a change from NICEs 2006 bipolar guideline, which did not specify any particular drug, but recommended that a drug from the antidepressant and antimanic drug classes should be used in combination to treat bipolar depression.
The updated guideline also recommends specific antipsychotics for the manic episodes of the disorder, no longer recommending the drug class as a whole.
NICE is now focusing on the effectiveness of individual drugs, rather than the tradition of recommending drug classes as a whole, says Richard Morriss, professor of psychiatry and mental health at the University Of Nottingham who led the development of the guideline.
The evidence base around the use of antidepressants has almost doubled since the previous guideline was published, he says. Bipolar depression looks a lot like unipolar depression, so the assumption was that treatment should be the same. But now we have gone from only having a weak evidence base to having evidence with statistical significance, Morriss says.
What Else Should I Consider Before Taking Mood Stabilisers
Medication can affect sexual desire , arousal and your ability to have an orgasm. If this happens, talk to your doctor. Changing the dose could help with this problem.
If you are thinking of trying for a baby, speak to your doctor about your medication.
Your doctor should give you information about the effects that medications can have during pregnancy.
If you are pregnant and need to take a mood stabiliser speak to your doctor. Some mood stabilisers can cause problems if you take them whilst you are pregnant. It is important that any decision about treatment during pregnancy weighs up the individual risks and benefits.
LithiumTaking lithium during pregnancy can cause heart problems in the foetus. Lithium should be not be taken when you are pregnant if possible.
ValproateValproate can harm an unborn baby. It can cause birth defects such as:
- spina bifida,
- problems with forming the face and skull, and
- problems forming the limbs, heart, kidney, urinary tract and sexual organs.
It can also cause developmental and learning problems such as:
- being late in learning to walk and talk,
- lower intelligence than other children of the same age,
- poor speech and language skills, and
- memory problems.
Children are also more likely to have autism or autistic spectrum disorders and signs of Attention Deficit Hyperactivity Disorder .
What Can I Expect After Treatment
For most people, a good treatment program can stabilize severe moods and provide effective symptom relief. Treatment that is continual has proven more effective in preventing relapses. Those who also have a substance abuse problem may need more specialized treatment.
Last reviewed by a Cleveland Clinic medical professional on 01/27/2018.
Women Who Are Pregnant Or Who May Become Pregnant
The research on the use of psychiatric medications during pregnancy is limited. The risks are different depending on which medication is taken, and at what point during the pregnancy the medication is taken. Decisions on treatments for all conditions during pregnancy should be based on each woman’s needs and circumstances, and based on a careful weighing of the likely benefits and risks of all available options, including psychotherapy , medication, or a combination of the two. While no medication is considered perfectly safe for all women at all stages of pregnancy, this must be balanced for each woman against the fact that untreated serious mental disorders themselves can pose a risk to a pregnant woman and her developing fetus. Medications should be selected based on available scientific research, and they should be taken at the lowest possible dose. Pregnant women should have a medical professional who will watch them closely throughout their pregnancy and after delivery.
Most women should avoid certain medications during pregnancy. For example:
Antidepressants, especially SSRIs, are considered to be safe during pregnancy. However, antidepressant medications do cross the placental barrier and may reach the fetus. Birth defects or other problems are possible, but they are very rare. The effects of antidepressants on childhood development remain under study.
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Who Experiences Bipolar Disorder
Bipolar disorder usually begins in older teens and young adults, with at least half of all cases appearing before age 25. Children and adolescents, however, can develop this disease in more severe forms and often in combination with attention deficit hyperactivity disorder . Some studies have indicated that bipolar depression is genetically inherited, occurring more commonly within families.
While bipolar disorder occurs equally in women and men, women are more likely to meet criteria for bipolar II disorder. Women with bipolar disorder may switch moods more quickly this is called “rapid cycling.” Varying levels of sex hormones and activity of the thyroid gland in the neck, together with the tendency to be prescribed antidepressants, may contribute to the more rapid cycling seen in women. Women may also experience more periods of depression than men.
An estimated 60 percent of all people with bipolar disorder have drug or alcohol dependence. It has also been shown to occur frequently in people with seasonal depression and certain anxiety disorders, like post-traumatic stress disorder .
Does Alcohol Affect My Mood Stabiliser
Alcohol is not recommended when using some mood stabilisers.
Drinking alcohol whilst taking valproate can increase your risk of liver damage. And drinking alcohol whilst taking lamotrigine can affect your ability to perform skilled tasks, such as driving.
Your doctor should talk to you about how alcohol may affect your medication.
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Bipolar Disorder Treatments You Should Know About
Though it can be managed, when left untreated, bipolar disorder can completely disrupt a persons life. This mental health condition causes unusual and sometimes extreme shifts in a persons mood, energy, and activity levels, affecting their judgment, ability to think clearly, relationships, and daily life in general. Thats where treatment comes in.
Theres no one magic way to ease symptoms of bipolar disorder. Instead, experts generally recommend that people with this condition undergo psychotherapy and take medication to help stabilize their mood.
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 .
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What Causes Bipolar Disorder
Although the exact cause is unknown, there does seem to be a genetic link, and you are more likely to get bipolar disorder if you have another family member with the condition.
Symptoms are often triggered by a stressful situation or circumstance. This may take the form of a relationship breakdown; physical, sexual, or emotional abuse; money problems; or the death of a close family member or loved one.
Symptoms are thought to be due to changes in the balance of some neurotransmitters in the brain, specifically noradrenaline, serotonin, and dopamine.
It can be hard to recognize bipolar disorder initially. During a manic phase, a person with bipolar disorder may be incredibly fun to be around. However, as the condition progresses, these manic episodes become more extreme.
Some people with bipolar disorder only experience slight mania and are mainly depressed. Misdiagnosis as depression is common. If an antidepressant is prescribed without a mood stabilizer, it will often catapult the person into a full-on manic state. Recognizing bipolar illness is important for treatment, as mood stabilizing agents are the best type of medication.
What About Psychotherapy For Help With Bipolar Depression
Along with medications for bipolar depression, patients may benefit from ongoing psychotherapy. This one-on-one therapy combines interpersonal psychotherapy with behavioral techniques to help patients learn how to more effectively manage interpersonal problems, stay on their medications, and normalize their lifestyle habits. The STEP-BD study mentioned earlier found that in addition to medications, adding a structured psychotherapy — such as cognitive behavioral therapy, interpersonal/social rhythm therapy, or family-focused therapy — can speed up treatment response in bipolar depression by as much as 150%.
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Learn About Your Bipolar Disorder Medication
When starting a new medication, educate yourself about how to take it safely. Questions to ask your doctor about any new prescription include:
How often should you talk with your doctor?
During an acute manic or depressive episode, youll likely need to talk with your doctor at least once a week to monitor your symptoms, medications, and any side effects youre experiencing. This will become less often as you start to recover. Once youre feeling better, youll likely still need to review things with your doctor every few months. However, its important to see your doctor right away if you experience any of the following:
- Suicidal or violent feelings.