Bipolar Disorder
How is it treated?
There are number of different options available for the treatment of bipolar disorders, consisting of drug and non-drug therapies. Many experts feel the best treatment is a combination of medications and psychosocial treatment and aim for similar goals to help guide in the treatment of individuals with bipolar disorder. Some of these goals include:
- Eliminate manic and depressive episodes and symptoms associated with those.
- Prevent relapses of manic and depressive episodes
- Find a therapy that will treat the symptoms, but also have the fewest adverse effects and fewest drug interactions.
- Treat substance abuse and use that may be present in addition to the disorder.
- Avoid stressors or substances that may lead to a manic or depressive episode.
Different classes of medications are used to treat bipolar disorder. Most of the medications used treat either mania or depression associated with bipolar disorder. There are a few drugs that have been shown to treat both types effectively.
One group of medications commonly used for the treatment of bipolar disorder are mood stabilizers. This group includes drugs such as lithium, divalproex, carbamazepine, and lamotrigine.
Lithium is one of the most widely used mood stabilizers to treat bipolar disorder and is often considered as first-line treatment for many individuals with mania. Lithium is also considered a miscellaneous antidepressant.
Divalproex, carbamazepine and lamotrigine were originally used only as anti-convulsant medications for the treatment of seizures, but are now also used to help treat various components of bipolar disorder. For example, divalproex and carbamazepine are used to help treat the symptoms of mania, while lamotrigine is used to help treat the symptoms of depression. More research is being done on other anticonvulsant medications to see if they have value in the treatment of bipolar disorders.
Newer anti-psychotics are the next group of medications that can be used to treat bipolar disorders. They include olanzapine, risperidone, quetiapine, aripiprazole, and ziprasidone. These medications are most effective for short-term treatment, especially for sudden manic episodes. Quetiapine (brand name: Seroquel), has been approved by the FDA for treatment of manic and depressive episodes.
Individuals who have manic episodes, who may or may not be receiving treatment for bipolar disorder, may need to be given additional medications for faster relief of manic symptoms and to help with sleep. Benzodiazepines are commonly used for this purpose. Some examples include lorazepam, alprazolam, and clonazepam.
Due to the possible teratogenic effects (causing developmental malformations in a fetus) of most of the medications used to treat bipolar disorder, finding treatment for women who are pregnant or breastfeeding may be difficult. Sometimes a class of drug called, calcium channel blockers are used. They have a lower teratogenic effect and have been shown to have some mood stabilizing properties.
Electroconvulsive therapy, ECT, is another option that is available for bipolar disorder treatment. ECT is usually reserved when more severe symptoms are present that are not effectively treated with medication or psychotherapy. It can also be used in situations where the risks of drug therapy are greater than the benefits the patient would get (i.e. pregnancy).
Psychotherapy (the treatment of mental and emotional disorders using a variety of psychological techniques) may also provide benefit in addition to medication therapy. Psychological techniques include enrolling in self-help and support groups, instruction on using coping skills, and education on how to recognize the early symptoms of manic or depressive episodes.
Finally, bipolar disorder can often be better controlled with good, regular sleep habits, proper nutrition and regular exercise. Additionally, learning to spot stressors (the events or conditions that cause stress) in order to effectively manage them may be beneficial.
Drug classes used to treat Bipolar Disorder Anticonvulsants Atypical Antipsychotics Calcium Channel Blockers Miscellaneous Antidepressants
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How is it treated?
