Bipolar disorder is a complex illness, which includes highs of mania and lows of depression. There are also mixed states that can reflect some of both types of episodes.
This disorder is broken down into two main types: type I and type II. Type I is considered more severe than II. Bipolar-I is the type you’d probably see in movies with extreme and long-lasting states.
Please note that there is also a cyclothymic disorder that is unofficially known as bipolar-III. It is much less severe but is longer lasting.
According to the National Alliance on Mental Illness (NAMI), bipolar disorder affects about 2.6% of the population. An overwhelming 86% of that number have been classified as severe cases.
Finding the right bipolar medication can be difficult without the right help. Finding a doctor you trust and can build a relationship with is a must. This is because some doctors stick to a certain method when prescribing medications. This method does not work for everyone.
Most patients with any type of bipolar diagnosis will tell you that being informed about treatment options ease the journey of finding what works. Having the ability to communicate with your doctor will also quicken the time it takes to find the right bipolar medication(s).
Unfortunately, with bipolar disorder, there is no known cure. When prescribed medications, you may be on them for years or the rest of your life. You also will likely change medications based on your presenting episodes.
We’re going to discuss each type of medication, the common side effects, and what the goal is by using them. Read on for a comprehensive list.
Types of Bipolar Medication
There are a few different types of drugs that are prescribed to treat particular symptoms of bipolar disorder. These classes of drugs include mood stabilizers, antipsychotics, anti-depressants, combination anti-depressant/antipsychotic, and anti-anxiety medications.
A doctor may prescribe only one of these medicines or a combination of them. Oftentimes, a combination of drugs have high success rates in people with severe bipolar disorder.
One of the first bipolar medications you may be put on is a mood stabilizer. This type of drug will help prevent and treat the highs and lows associated with the disorder.
These medicines are not meant to keep you from having any type of differing mood. They are meant for treating a full-blown episode of mania or depression.
Depending on what end of the spectrum you’re falling on, your doctor may prescribe something like lithium to help with mania. If you’re leaning toward depression, he might prescribe lamotrigine.
Other medications included in the mood stabilizers category would be Depakote, Epitol, and Depakene. Lamotrigine is generic for Lamictal.
Certain medications will require blood tests–the one most noted for this is lithium. This is to be sure that the medicine doesn’t make you toxic. It is also to be sure that the levels in your blood are therapeutic for you.
There are a few other side-effects to mood-stabilizers. The most commonly noted one is tremors. Also in this list is thirst, diarrhea, vomiting, and drowsiness.
If you experience more serious side-effects, consult your doctor. These may include blurred vision, excessive weight gain, coma, fainting. This is not a complete list, so if you think you are experiencing serious problems, PLEASE contact your doctor as it may be a drug reaction or allergy.
These bipolar medications are more typically prescribed for lasting manic symptoms. These symptoms can include hallucinations, delusions, and overall psychosis.
They are secondarily used to help with anxiety and insomnia.
The list of antipsychotic medications to treat bipolar disorder include Geodon, Seroquel, Zyprexa, Risperdal, Clozaril, Vraylar, Saphris, and Abilify.
Latuda is also considered an anti-psychotic. However, it is heavily marketed as a specific treatment for bipolar depression.
These medications are most often known for their weight gain side-effect. However, they also may cause thirst and dry mouth, drowsiness, and blurred vision.
If your doctor decides to find another treatment, he will slowly lower your dose. It is important to follow this. Although these drugs are non-narcotic, some of them can mimic withdrawal symptoms. One drug noted for this is Seroquel.
There are also an older group of anti-psychotics that aren’t as commonly used for bipolar disorder anymore. This is because many doctors find them less effective. However, a few of the more noted prescriptions are Thorazine and Haldol.
Anti-depressants break down into different classes like SSRIs and SNRIs. Regardless, they are not technically approved by the FDA for the treatment of bipolar disorder.
However, that doesn’t stop doctors from prescribing them. They might not work for everyone and they could potentially swing you from a depression into a severe mania. BUT the fact is, at the right dose, they can work–it just depends on your brain’s chemistry.
If these are prescribed, they will probably be prescribed WITH a mood stabilizer to prevent a full-on “switch” or “flip” from depression to mania.
The most common antidepressants prescribed for bipolar disorder include Prozac, Zoloft, Effexor, and Wellbutrin. The jury is still out on using these for this purpose. So if your doctor refuses this treatment, this may be the reason.
There is a combination drug called Symbyax. It is basically Prozac (anti-depressant) and Zyprexa (anti-psychotic) in one medicine. This bipolar medication is used to treat the depressive side of the disorder.
Typical side effects of this drug include an increase in appetite, weight gain (often from the appetite,) decrease in sexual desire, dry mouth, twitching, and diarrhea.
Although it is approved by the FDA for this use, patients have “switched” after this medication has taken effect. The weight gain is also something to be seriously noted. This may actually cause your doctor to stop treatment.
This type of drug is not always used to treat bipolar disorder, but to aid in coping with anxiety. Anxiety can have an effect on sleep (which can affect the overall disorder.)
Most often benzodiazepines are prescribed for short-term use as they are highly addictive. These include Xanax, Klonopin, Ativan, Librium, and others.
Their side effects are similar to the ones in earlier sections, but also include withdrawal when stopping after long-term use. Addiction with long-term, continued use is also possible.
Keep in mind, there are non-narcotic anti-anxiety drugs. They are somewhat lesser known but quite effective. The most commonly prescribed is Buspar. It is far less sedating than the above listed. Also, it is non-addictive.
Many SSRIs (like Prozac) can act as an anti-anxiety in addition to their anti-depressant properties.
The Complete List:
Here is a comprehensive list of medications used to treat bipolar disorder. They include everything listed above, as well as others.
- Abilify Maintena
- Abilify MyCite
- Depakote ER
- Depakote Sprinkles
- divalproex sodium
- Lamictal CD
- Lamictal ODT
- Risperdal Consta
- Risperdal M-Tab
- Seroquel XR
- valproic acid
- Zyprexa Intramuscular
- Zyprexa Zydis
High on Life
Of course, no matter what type of bipolar medication you and your doctor decide on, certain changes in your lifestyle may be necessary.
The use of illicit drugs and over-consumption of alcohol is definitely something to stop. These can interfere with your medications.
Aiming for a full night’s sleep is helpful. Being well-rested can help prevent a manic episode.
Eating well and exercising will only benefit you. These can aid with weight, but also release feel-good chemicals in the brain.
An added benefit of healthy eating and exercise will help curb some of the potential weight gain. Keeping weight low will help offset the possibility of diabetes that many of these medications put you at risk for.
If you find the weight gain unmanageable to the point of it affecting your self-esteem and confidence, talk to your doctor.
Having a sense of purpose in life–be it your job, children, volunteering, etc.–will allow you to keep going when things get rough. This allows for fulfillment which can relieve depression. This also may help you make better choices when manic.
A therapist or counselor can begin to help modify the problem behaviors that present with either state. They can also help you see triggers and warning signs of a “switch.”
This part of treatment will aid in teaching you healthy coping mechanisms and skills. A couple of these may include meditation or grounding.
Therapists and counselors will often work WITH your doctor to find the best treatment.
Keeping to your treatment plan and taking your medications as prescribed will result in fewer major episodes. The medication cannot do EVERYTHING. You will have to work on your recovery as well.
No matter what type of medication you end up using, there will always be a risk of side effects. This must be weighed out against the benefits of these drugs. The manageability of your life while on the medicine must also be considered.
Please be aware that the use of any psychotropic drugs can cause suicidal thoughts. If you start to have these, contact your doctor immediately.
If you can’t get in touch and you feel like you’re a threat to yourself or others, please call the National Suicide Hotline.
Finding your triggers to episodes is a major part of staying happy and healthy. When you sense yourself falling down a hole or becoming high as a kite, talk with your doctor to begin adjusting your medicine.
As mentioned earlier, your doctor may prescribe multiple drugs to help control your bipolar disorder. This may sound scary, but it may be the best bet for addressing multiple problems.
A group of medications may look something like this: Lithium to control how high your mania gets, while preventing depression, a low dose of Prozac to aid with anxiety and prevent a slip into depression, Seroquel to help with sleep and agitation/irritability from mania, and Buspar for General Anxiety Disorder (made worse by bipolar disorder.)
When and if you do change medication, do your research. Medicine can often be overwhelmingly expensive–even with insurance. Be sure to exhaust all options and consider comparing your medication prices with us.