Medications used in the treatment of bipolar disorder
A class of medications called mood stabilizers have been shown to be effective in preventing both the manic and depressive episodes of bipolar disorder, and/or lessening their symptoms. A related class of medications, referred to as augmenting agents are used in combination with other medications to help improve response for those with depression.
Two types of medications are commonly used as mood stabilizers: lithium and atypical mood stabilizers, which are usually members of the anticonvulsant drug category.
The element lithium has been used as a mood stabilizer for nearly 40 years. Lithium has been shown to be particularly effective in patients whose manic episodes consist mostly of elevated mood or euphoria, as compared with those whose episodes are marked mostly by rapid cycling, agitation or negative emotions. Lithium is also useful in treating the depressive episodes in bipolar disorder either alone or when combined with other medications.
Side effects associated with lithium include:
- weight gain
- nausea, vomiting or diarrhea
- dry mouth and excessive thirst
- more frequent urination
- renal (kidney) damage (seen in a small percentage of patients)
To maximize the benefits of lithium and minimize these side effects, and to protect the thyroid and kidneys (both of which can be impacted by lithium in the bloodstream), regular blood tests are required when lithium is prescribed. Periodic blood tests to measure kidney function should also be arranged.
ATYPICAL MOOD STABILIZERS (ANTICONVULSANTS)
This class of medications can be used in some patients to treat seizures. They are also employed as mood stabilizers in the treatment of bipolar disorder, and as augmenting agents for depression, especially treatment-resistant depression.
Depending upon the class of anticonvulsant, side effects may include:
- Weight gain or loss
- Gastrointestinal problems
- Vision problems
- Memory or concentration problems
As is the case with lithium, regular blood tests are recommended with the use of some anticonvulsants to monitor the dosage and to identify potentially dangerous side effects.
COMBINING MOOD STABILIZERS WITH ANTIDEPRESSANTS IN THE TREATMENT OF BIPOLAR DISORDER
There are a range of antidepressant medications available to manage the symptoms of depression. Antidepressants are also sometimes employed in the treatment of bipolar disorder, but only with caution and in combination with mood stabilizing medication. If taken alone, antidepressants can increase the probability of an episode of mania in a small percentage of patients with bipolar disorder.