Treatment for bipolar disorder

There is no cure for bipolar disorder.  However, treatments are available and have proven to be very successful in most cases.  Good treatment helps people gain control of their mood swings and other related symptoms of bipolar.  Because bipolar disorder is recurrent and lifelong, people with bipolar disorder need life long treatment.  Both medication and psychotherapy are needed to reduce symptoms and prevent relapse.

The following mood stabilizing medications are used to treat bipolar disorder:

• Lithium (sometimes known as Eskalith or Lithobid) was the first mood-stabilizing medication approved by the U.S. Food and Drug Administration (FDA) in the 1970s for treatment of mania. It is often very effective in controlling symptoms of mania and preventing the recurrence of manic and depressive episodes as in bipolar disorder.
• Valproic acid or divalproex sodium (Depakote), approved by the FDA in 1995 for treating mania, is a popular alternative to lithium for bipolar disorder. It is generally as effective as lithium for treating bipolar disorder.
• More recently, the anticonvulsant lamotrigine (Lamictal) received FDA approval for maintenance treatment of bipolar disorder.
• Other anticonvulsant medications, including gabapentin (Neurontin), topiramate (Topamax), and oxcarbazepine (Trileptal) are sometimes prescribed. No large studies have shown that these medications are more effective than mood stabilizers.

Other medications, called “Atypical antipsychotic medications” are also sometimes used to treat symptoms of bipolar disorder. Often, these medications are taken with other medications. Atypical antipsychotic medications are called “atypical” to set them apart from earlier medications, which are called “conventional” or “first-generation” antipsychotics. (www.nimh.nih.gov).  These include:

• Olanzapine (Zyprexa), when given with an antidepressant medication, may help relieve symptoms of severe mania or psychosis.
• Aripiprazole (Abilify), like olanzapine, is approved for treatment of a manic or mixed episode.
• Quetiapine (Seroquel) relieves the symptoms of severe and sudden manic episodes.
• Risperidone (Risperdal) and ziprasidone (Geodon) are other atypical antipsychotics that may also be prescribed for controlling manic or mixed episodes.

Further, antidepressant medications are sometimes used to treat symptoms of depression in bipolar disorder. Most people with bipolar disorder struggle significantly with depression.  People with bipolar disorder who take antidepressants often take a mood stabilizer too. Doctors usually require this because taking only an antidepressant can increase a person’s risk of switching to mania or hypomania. Commonly prescribed anti-depressants to treat bipolar disorder include:

• Fluoxetine (Prozac)
• Paroxetine (Paxil)
• Sertraline (Zoloft)
• Bupropion (Wellbutrin)

Before taking any medication for bipolar, it is important to discuss the many side effects with your doctor.

An additional treatment for bipolar disorder is psychotherapy.  This “talk” therapy, can be an effective treatment for bipolar disorder. It can provide support, education, and guidance to people with bipolar disorder and their families. Some psychotherapy treatments used to treat bipolar disorder include:

• Cognitive behavioral therapy (CBT) helps people with bipolar disorder learn to change harmful or negative thought patterns and behaviors.
• Family-focused therapy includes family members. It helps enhance family coping strategies, such as recognizing new episodes early and helping their loved one. This therapy also improves communication and problem-solving.
• Interpersonal and social rhythm therapy helps people with bipolar disorder improve their relationships with others and manage their daily routines. Regular daily routines and sleep schedules may help protect against manic episodes.
• Psychoeducation teaches people with bipolar disorder about the illness and its treatment. This treatment helps people recognize signs of relapse so they can seek treatment early, before a full-blown episode occurs. Usually done in a group, psychoeducation may also be helpful for family members and caregivers.

A licensed psychologist, social worker, or counselor typically provides these therapies. This mental health professional often works with the psychiatrist to track progress. The number, frequency, and type of sessions should be based on the treatment needs of each person.

Again, although there is no cure for bipolar disorder, proven treatments have given patients hope and much more consistent, high functioning lives.

(nimh.nih.gov)