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Medication Treatment For Bipolar Disorder
- By Site Admin
- Published 03/13/2008
- Bipolar Disorder
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Site Admin
Name: Bob
Age: 47
Location: U.S.A.
About Me:
For over 30 years, starting when I was old enough to begin to understand life, I have dealt with people suffering or trying to deal with various diseases and conditions, as I also suffered a long battle. I am not a doctor, I do not pretend to be one, what I am, is a caring person in real life. I hope anyone able to that stops by here will also donate some time to people in need of answers and a friendly chat. This site "Donations For Us" is about giving, donations are not only about money.
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Principles of Medication Management
For medication to be of benefit, you should carefully follow the prescribed treatment and take note of your symptoms and side effects. If side effects develop, these should be reported to your doctor as soon as possible to avoid prolonged discomfort. It is strongly advised that you do not stop medication abruptly before first consulting with your doctor. This could bring on a return of a manic or depressive episode. Alcohol, illicit drugs, and other prescribed medicines may cause your medication for bipolar disorder to be ineffective and
may increase side effects. You should report all other medications and substances you are taking to your doctor to ensure that none adversely interact with the medication prescribed for bipolar disorder. Using substances other than prescribed medication can result in a slower time to recovery with treatment, or even poor response to treatment, and more lifetime psychiatric hospitalisations. Research has shown that substance use impacts negatively on the course and outcome of bipolar disorder and may be a contributing factor to
relapse and episode recurrences. Effective medical management of bipolar disorder requires you to monitor your symptoms and side effects, and work with your doctor to adjust dosages or types of medications.
Phases of Treatment
There are usually three phases to medical treatment for bipolar disorder. The most important aim, if you are experiencing an episode of mania, hypomania, or major depression, is to control or eliminate the symptoms so that they can return to a normal level of day-to-day functioning. The duration of this acute phase of treatment may last from 6 weeks to 6 months. Sometimes, longer periods are necessary in order to find the most effective medications with minimal side effects. Continuation treatment, which is the next phase, may last from 4 to 9 months. In this phase, the main aim is to maintain the symptom-free state by preventing relapse, which is the return of the most recent mood episode.
Keeping Your Balance
The third phase, the maintenance phase, is critical and essential for all patients with bipolar disorder. The goal for maintenance treatment is to prevent recurrence, that is, to prevent new episodes of mania, hypo-mania, or depression from occurring. For bipolar patients, as with other medical conditions such as diabetes or hypertension, maintenance treatment may last 5 years, 10 years, or a lifetime. But remember, prolonged symptom control will help you to function better in your daily lives. For all phases of treatment and all medications, patients must take the prescribed medication/s on a daily basis. Unlike medications like paracetamol or antibiotics that are taken only
when a person actually experiences a headache or has the flu, medications for bipolar disorder must be taken regularly – on both good days and bad days – at the same dosage.
Types of Medications for Bipolar Disorder
Mood Stabilizers
A mood stabilizer is a medication that is used to decrease the chance of having further episodes of mania or depression. They are the first line agents for bipolar disorder. Depending on the associated symptoms with this disorder, anti-depressants or anti-psychotics may also be used. A mood stabilizer is given to a person as a maintenance medication because it regulates mood swings but doesn’t take away the cause. Feeling well does not mean you can stop taking mood stabilizers, it means the medication is keeping you stable. The most common mood stabilizers are:
Lithium Carbonate
Carbamazepine
Sodium Valproate
Sometimes
these medications are used on their own or in combination with other medications.
Antidepressants
Antidepressants can also be used with mood stabilizers in the acute, continuation, and/or maintenance phases of medical treatment. There is no one particular antidepressant that is more effective than the others in bipolar disorder. In fact, there is a significant risk for antidepressants to induce or cause a “switch” to manic or hypo-manic episodes, especially if a patient on antidepressants is not taking a mood stabilizer. Because all types of antidepressants seem to be equally effective and it takes several weeks to work effectively, often it is the side-effects that determine which antidepressants are selected for an individual.
In general, if you do not respond well to one type (or class) of antidepressants, you may tolerate and respond to a different class, or even to one in the same class. Common antidepressants include:
Selective serotonin reuptake inhibitors (SSRIs) - fluoxetine, paroxetine, sertraline
Tricyclics - imipramine, amitriptyline, desipramine, dolthiepin
Monoamine oxidase inhibitors (MAOIs) - phenelzine and tranylcypromine
Common side effects of antidepressants include: dry mouth, blurred vision, constipation, mild sedation, and difficulty urinating. Some older patients may be more sensitive to these side effects. Side effects are usually seen quite early on or when the dosage is increased. Lower doses commonly have fewer side effects, and generally, the newer medications have fewer side effects in the short and longer term. It is important that you distinguish depressive symptoms from side effects of the antidepressant. You should discuss this with your
doctor before you begin taking the medication. Some medications can cause side effects that are very similar to the depressive symptoms, e.g., difficulty sleeping, dry mouth, and sexual difficulties.
Antipsychotic Medication
Anti-psychotics may also be used both in the acute phase of the disorder and sometimes as a longer term treatment. Common anti-psychotic agents include haloperidol, chlorpromazine, thioridazine, risperidone, and olanzapine. These medications are often combined with mood stabilizers to assist in controlling hallucinations, or delusions, to induce sleep, to reduce inappropriate grandiosity, or decrease irritability or impulsive behaviours. These medications are usually not used for treating hypo-mania. Although antipsychotics are most often used in treatment of the acute phase of mania, some patients may continue on smaller dosages to ensure that they do not
experience a relapse of psychotic or manic symptoms.
Some side effects of anti-psychotic medication include motor and subjective restlessness, trouble concentrating, blurred vision, dry mouth, and difficulty urinating. These side effects can be minimized by using the lowest necessary doses of the medication. Another often used medication is clonazepam, which is classed under the benzodiazepines. This is used as an adjunct with other medications (mood stabilizers and anti-psychotics) to aid in inducing sleep, reducing psychomotor agitation, and slowing racing thoughts and pressured speech.
Remember that it is very important that you communicate openly with your prescribing doctor or psychiatrist. In general, if you don’t respond well to one type of medication, you may tolerate and respond to a different type. Use this worksheet to record the types of medication you are currently taking, the dosage, and what side effects you might be experiencing. You might also want to take note of how you feel after taking the medication, whether or not it has been effective. Once you’ve recorded all this information, discuss your
medication treatment with your doctor, especially if you are concerned about the way you feel. This information could also be valuable as a record of the medications you have taken in the past.
For medication to be of benefit, you should carefully follow the prescribed treatment and take note of your symptoms and side effects. If side effects develop, these should be reported to your doctor as soon as possible to avoid prolonged discomfort. It is strongly advised that you do not stop medication abruptly before first consulting with your doctor. This could bring on a return of a manic or depressive episode. Alcohol, illicit drugs, and other prescribed medicines may cause your medication for bipolar disorder to be ineffective and
may increase side effects. You should report all other medications and substances you are taking to your doctor to ensure that none adversely interact with the medication prescribed for bipolar disorder. Using substances other than prescribed medication can result in a slower time to recovery with treatment, or even poor response to treatment, and more lifetime psychiatric hospitalisations. Research has shown that substance use impacts negatively on the course and outcome of bipolar disorder and may be a contributing factor to
relapse and episode recurrences. Effective medical management of bipolar disorder requires you to monitor your symptoms and side effects, and work with your doctor to adjust dosages or types of medications.
Phases of Treatment
There are usually three phases to medical treatment for bipolar disorder. The most important aim, if you are experiencing an episode of mania, hypomania, or major depression, is to control or eliminate the symptoms so that they can return to a normal level of day-to-day functioning. The duration of this acute phase of treatment may last from 6 weeks to 6 months. Sometimes, longer periods are necessary in order to find the most effective medications with minimal side effects. Continuation treatment, which is the next phase, may last from 4 to 9 months. In this phase, the main aim is to maintain the symptom-free state by preventing relapse, which is the return of the most recent mood episode.
Keeping Your Balance
The third phase, the maintenance phase, is critical and essential for all patients with bipolar disorder. The goal for maintenance treatment is to prevent recurrence, that is, to prevent new episodes of mania, hypo-mania, or depression from occurring. For bipolar patients, as with other medical conditions such as diabetes or hypertension, maintenance treatment may last 5 years, 10 years, or a lifetime. But remember, prolonged symptom control will help you to function better in your daily lives. For all phases of treatment and all medications, patients must take the prescribed medication/s on a daily basis. Unlike medications like paracetamol or antibiotics that are taken only
when a person actually experiences a headache or has the flu, medications for bipolar disorder must be taken regularly – on both good days and bad days – at the same dosage.
Types of Medications for Bipolar Disorder
Mood Stabilizers
A mood stabilizer is a medication that is used to decrease the chance of having further episodes of mania or depression. They are the first line agents for bipolar disorder. Depending on the associated symptoms with this disorder, anti-depressants or anti-psychotics may also be used. A mood stabilizer is given to a person as a maintenance medication because it regulates mood swings but doesn’t take away the cause. Feeling well does not mean you can stop taking mood stabilizers, it means the medication is keeping you stable. The most common mood stabilizers are:
Lithium Carbonate
Carbamazepine
Sodium Valproate
Sometimes
Antidepressants
Antidepressants can also be used with mood stabilizers in the acute, continuation, and/or maintenance phases of medical treatment. There is no one particular antidepressant that is more effective than the others in bipolar disorder. In fact, there is a significant risk for antidepressants to induce or cause a “switch” to manic or hypo-manic episodes, especially if a patient on antidepressants is not taking a mood stabilizer. Because all types of antidepressants seem to be equally effective and it takes several weeks to work effectively, often it is the side-effects that determine which antidepressants are selected for an individual.
In general, if you do not respond well to one type (or class) of antidepressants, you may tolerate and respond to a different class, or even to one in the same class. Common antidepressants include:
Selective serotonin reuptake inhibitors (SSRIs) - fluoxetine, paroxetine, sertraline
Tricyclics - imipramine, amitriptyline, desipramine, dolthiepin
Monoamine oxidase inhibitors (MAOIs) - phenelzine and tranylcypromine
Common side effects of antidepressants include: dry mouth, blurred vision, constipation, mild sedation, and difficulty urinating. Some older patients may be more sensitive to these side effects. Side effects are usually seen quite early on or when the dosage is increased. Lower doses commonly have fewer side effects, and generally, the newer medications have fewer side effects in the short and longer term. It is important that you distinguish depressive symptoms from side effects of the antidepressant. You should discuss this with your
doctor before you begin taking the medication. Some medications can cause side effects that are very similar to the depressive symptoms, e.g., difficulty sleeping, dry mouth, and sexual difficulties.
Antipsychotic Medication
Anti-psychotics may also be used both in the acute phase of the disorder and sometimes as a longer term treatment. Common anti-psychotic agents include haloperidol, chlorpromazine, thioridazine, risperidone, and olanzapine. These medications are often combined with mood stabilizers to assist in controlling hallucinations, or delusions, to induce sleep, to reduce inappropriate grandiosity, or decrease irritability or impulsive behaviours. These medications are usually not used for treating hypo-mania. Although antipsychotics are most often used in treatment of the acute phase of mania, some patients may continue on smaller dosages to ensure that they do not
experience a relapse of psychotic or manic symptoms.
Some side effects of anti-psychotic medication include motor and subjective restlessness, trouble concentrating, blurred vision, dry mouth, and difficulty urinating. These side effects can be minimized by using the lowest necessary doses of the medication. Another often used medication is clonazepam, which is classed under the benzodiazepines. This is used as an adjunct with other medications (mood stabilizers and anti-psychotics) to aid in inducing sleep, reducing psychomotor agitation, and slowing racing thoughts and pressured speech.
Remember that it is very important that you communicate openly with your prescribing doctor or psychiatrist. In general, if you don’t respond well to one type of medication, you may tolerate and respond to a different type. Use this worksheet to record the types of medication you are currently taking, the dosage, and what side effects you might be experiencing. You might also want to take note of how you feel after taking the medication, whether or not it has been effective. Once you’ve recorded all this information, discuss your
medication treatment with your doctor, especially if you are concerned about the way you feel. This information could also be valuable as a record of the medications you have taken in the past.
