Bipolar Medication Guide
Medications and Drugs for Bipolar Disorder Treatment
In This Article
If someone close to you has bipolar disorder, your love and support can make a difference in treatment and recovery. You can help by learning about the illness, offering hope and encouragement, keeping track of symptoms, and being a partner in treatment. But caring for a person with bipolar disorder will take a toll if you neglect your own needs, so it’s important to find a balance between supporting your loved one and taking care of yourself.
The role of medication in bipolar disorder treatment
If you have bipolar disorder, medication will likely be the foundation of your treatment plan. Medication can bring mania and depression under control and prevent relapse once your mood has stabilized. You may not like the idea of taking bipolar medication long term, especially if you’re struggling with unpleasant side effects. But just as a diabetic needs to take insulin in order to stay healthy, taking medication for bipolar disorder will help you maintain a stable mood.
However, do not expect medication alone to solve all your problems. There are plenty of other steps you can take to manage your symptoms and reduce the amount of medication required. Medication is most effective when used in combination with other bipolar disorder treatments, including therapy, self-help coping strategies, and healthy lifestyle choices.
Tips for getting the most out of medication for bipolar disorder
- Avoid antidepressants. The treatment for bipolar depression is different than for regular depression. In fact, antidepressants can actually make bipolar disorder worse or trigger a manic episode. Try mood stabilizers first and never take antidepressants without them, as antidepressants can trigger mania and rapid mood cycling when used on their own.
- Take advantage of natural mood stabilizers. Your lifestyle has an impact on your symptoms. If you make healthy daily choices, you may be able to reduce the amount of medication you need. Mood stabilizers that don’t require a prescription include keeping a strict sleep schedule, exercising regularly, practicing relaxation techniques, and developing a solid support system.
- Add therapy to your treatment plan. Research shows that people who take medication for bipolar disorder tend to recover much faster and control their moods better if they also get therapy. Therapy gives you the tools to cope with life's difficulties. monitor your progress, and deal with the problems bipolar disorder is causing in your personal and professional life.
- Continue taking medication, even after you feel better. The likelihood of having a relapse is very high if you stop taking your bipolar medication. Suddenly stopping medication is especially dangerous. Talk to your doctor before you make any changes, even if you believe you no longer need medication. Your doctor can help you make any adjustments safely.
Finding the right bipolar disorder medication
It can take a while to find the right bipolar medication and dose. Everyone responds to medication differently, so you may have to try several bipolar disorder drugs before you find the one that works for you. Be patient, but don’t settle for a bipolar medication that makes you feel lousy, either.
Once you've discovered the right bipolar disorder drug or drug cocktail, it may still take time to determine the optimal dose. In the case of mood stabilizing medications such as lithium, the difference between a beneficial dose and a toxic one is small. Continue taking your medication even after you feel better as the likelihood of having a relapse is very high. Frequent office visits to re-evaluate your bipolar medication needs and careful monitoring of symptoms and side effects will help you stay safe.
Learn about your bipolar disorder medication
When starting a new medication for bipolar disorder, educate yourself about how to take it safely. Questions to ask your doctor about any new prescription include:
- Are there any medical conditions that could be causing or exacerbating my mood swings?
- What are the side effects and risks of the medication you are recommending?
- When and how should I take this medication?
- Are there any foods or other substances I will need to avoid?
- How will this drug interact with my other prescriptions?
- How long will I have to take this medication?
- Will withdrawing from the drug be difficult if I decide to stop?
- Will my symptoms return when I stop taking the medication?
How often should I talk with my doctor?
During acute mania or depression, most people talk with their doctor at least once a week, or even every day, to monitor symptoms, medication doses, and side effects. As you recover, you will see your doctor less often; once you are well, you might see your doctor for a quick review every few months. Regardless of scheduled appointments or blood tests, call your doctor if you have:
- Suicidal or violent feelings
- Changes in mood, sleep, or energy
- Changes in medication side effects
- Need for over-the-counter medication (cold or pain medicine)
- An acute medical illness or need for surgery, extensive dental care, or changes in other medicines
- A change in your medication situation, such as pregnancy
Source: Treatment of Bipolar Disorder: A Guide for Patients and Families
Generic vs. Brand-Name Drugs
Generic drugs have the same use, dosage, side effects, risks, safety profile, and potency as the original brand-name drug. The main reason why generic drugs are cheaper than brand-name drugs is that the generic drug manufacturer does not need to recoup huge expenses for developing and marketing a drug. Once the patent for the original drug has expired, other manufacturers can produce the same drug with the same ingredients at a markedly lower cost.
Occasionally, brand-name drugs have different coatings or color dyes to change their appearance. In rare cases, these extra ingredients will make the generic form of the drug less tolerable, so if your condition worsens after switching from a brand-name to a generic drug, consult your doctor. In most cases, however, generic drugs are just as safe and effective as brand-name drugs, and a lot easier on your wallet.
Taking medication for bipolar disorder responsibly
All prescription drugs come with risks, but if you take your bipolar disorder medications responsibly and combine them with therapy and healthy lifestyle choices, you can minimize the risks and maximize your chances of treatment success.
Take your bipolar medication as prescribed
You may be tempted to stop taking your bipolar disorder medication if you're experiencing side effects. Or conversely, you may want to stop taking your pills because you feel great and don't think you need them anymore. However, stopping maintenance medication comes with a high risk of relapse. Stopping cold turkey is even more risky.
Before you make any bipolar medication changes, talk to you doctor. If you don't like the way the drug makes you feel or if it's not working, there may be other options you can try. And if you decide that medication is not for you, your doctor can help you taper off the drugs safely.
Keep track of side effects
Track any side effects you experience. Using a log, keep a record of your symptoms, when they occur, and how bad they are. Bring the worksheet to your doctor. He or she may have suggestions for minimizing the side effects. If side effects are severe, your doctor may switch you to another drug or change your bipolar medication dose.
Be aware of potential drug interactions
You should always check for drug interactions before taking another prescription medication, over-the-counter drug, or herbal supplement. Drug interactions can cause unexpected side effects or make your bipolar disorder medication less effective or even dangerous. Mixing certain foods and beverages with your bipolar medication can also cause problems.
Talk to your doctor about special precautions for the bipolar medication or medications you’re taking. You can also learn about potential interactions by reading drug labels or talking to your pharmacist.
Tips for managing bipolar disorder medications
- Use a daily reminder/medication saver system to make sure you are taking all of the necessary medications.
- Throw away old medications or those you are no longer taking.
- Realize that medications work best when you are making other healthy choices. Don’t expect a pill to fix a bad diet, lack of exercise or an abusive or chaotic lifestyle.
- Reduce or discontinue the use of alcohol. Alcohol is a depressant and makes recovery even more difficult. It can also interfere with the way your medication works.
Source: Depression and Bipolar Support Alliance
Lithium: The first mood stabilizer for bipolar disorder
Mood stabilizers are medications that help control the highs and lows of bipolar disorder. They are the cornerstone of treatment, both for mania and depression. Lithium is the oldest and most well-known mood stabilizer. It is highly effective for treating mania.
Lithium can also help bipolar depression. However, it is not as effective for mixed episodes or rapid cycling forms of bipolar disorder. Lithium takes from one to two weeks to reach its full effect.
Common side effects of lithium
The following side effects are common on lithium. Some may go away as your body adapts to the medication.
- Weight gain
- Weakness or fatigue
- Excessive thirst; increased urination
- Stomach pain
- Thyroid problems
- Memory and concentration problems
- Nausea, vertigo
The importance of regular blood tests
If you take lithium, it’s important to have regular blood tests to make sure your dose is in the effective range. Doses that are too high can be toxic. When you first start taking it, your doctor may check your blood levels once or twice a week. Once the right dose has been determined and your levels are steady, blood tests will be less frequent.
However, it’s still important to get blood tests every two to three months, since many things can cause your lithium levels to change. Even taking a different brand of lithium can lead to different blood levels.