Bipolar medication should treat bipolar symptoms
All of my research and experience has convinced me that the primary goal of bipolar medication MUST be mood stabilization.
Although some other treatments are available and come in and out of fashion, in this section our major focus will be on mood stabilizing bipolar drugs.
Obviously the primary goal of taking medication is to treat bipolar symptoms, first and foremost.
When a person has manic-depressive illness, there are 4 main things they need from their bipolar meds:
1. Episode Prevention: You need to avoid both manic and depressive episodes. Remember, each episode you have increases the likelihood of further episodes - and failure to medicate is major cause of relapse (the return of serious bipolar symptoms).
2. Mood Control: Bipolar is a mood disorder so mood control is the primary goal. This is why the mood stabilizers are your best bet for effective bipolar medication - they treat both mania AND depression - (ie both of the both bipolar symptoms - as well as protecting you from future episodes.
3. Neural Protection: It has been shown that each extreme mood episode can cause damage to the brain. However, some meds actually help protect the brain from damage.
4. Treatment for an Acute Phase: If you are already in the grip of pronounced mania or depression and are exhibitig sever bipolar symptoms, you need to return to a balanced mood ASAP.
Best drugs for bipolar symptoms
Today there too many bipolar drugs in use to discuss them all in one webpage. Also, this is an area where you should seek expert advice from a specialist who has lots of bipolar experience.However, there are clear treatment guidelines and there is a definite gold standard approach that emphasizes trying the proven mood stabilizers first.
It is therefore possible to suggest that these mood stabilizers are the bipolar medications to try first. If your doctor does not suggest one of these (maybe in combination with something else), you should ask for some more information.1. Lithium 2. Lamictal (lamotrigine) 3. Depakote (sodium valproate).
Bipolar disorder drugs to avoid
For people with bipolar disorder, it is more typical to suffer from bipolar symptoms of depression than mania.
Although the fallout from manic episodes can be particularly destructive, and it is occurrence of mania that characterizes bipolar disorder, most bipolar people will spend more time being struggling with teh bipolar symptoms of depression rather than mania.
Also, research shows that bipolar depression is harder to treat than bipolar mania. And - as many of us found out the hard way - it is still common for medical professionals to misdiagnose bipolar disorder as depression.
For these reasons, many bipolar people are given antidepressant drugs. DON'T TAKE THEM UNLESS YOU ALSO TAKE A MOOD STABILIZER AND/OR HAVE HAVE A DETAILED JUSTIFICATION FROM YOUR PSYCHIATRIST! The latest research suggests that antidepressants are either pointless or downright dangerous if what you really have is manic-depressive illness.
There is no good evidence that continuous use of an antidepressant prevents further episodes of bipolar depression. EVEN WORSE - there is a definite risk of them causing a switch to mania.
In particular, SSRI drugs are NOT effective bipolar medications. However, "Benzo" antidepressants such as Klonopin, Xanax, Valium, or Ativan may be very helpful for anxiety and panic.
Also steer away from atypical anti-psychotics such as Seroquel (quetiapine) and Zyprexa (olanzapine) as these can lead to substantial weight gain and diabetes.
Although these drugs have recently been fashionable bipolar medications and do have some research to support their effectiveness, there is a lot of debate about the conduct of the drug companies and the doctors they paid to conduct these studies. Also, in some US states there have been lawsuits and legal settlements. There is evidence that these drugs have been pushed in inappropriate ways, and have severe side effects that consumers are not suitably warned about.
Abilify is popular becuase some believe it does not have these same weight gain problems and there is an emerging body of evidence to support its effectiveness for treating both mixed episodes and bipolar mania.
Does Abilify cause weight gain?
Wikipedia article on bipolar drugs
Bipolar meds tips
We discuss lithium side effects, toxicity symptoms, and compliance tips in lots of detail elsewhere on the Bipolar Lives website, so we won't deal with lithium in any more detail here.
1. Depakote (Valproate)
This is one of the most tried and tested bipolar meds and is an excellent mood stabilizer to consider, especially for men. Like all drugs, there can be an adjustment period, with side effects such as nausea and indigestion, sleepiness, and hand tremors. To cope with these while you settle in, we suggest you ask for the slow release version and take your tablets after food. If they make you feel sleepy, then try taking your dose at night. Taking your meds with food and cutting down on caffeine will help with hand tremors (although most people don't have this side effect).
2. Lamictal (Lamotrigine)
Fast emerging as a favored treatment, Lamictal is very useful for the treatment and prevention of bipolar depression and rapid-cycling. However, some studies suggest Lamictal may be less effective for mania. It is often used in combination with another bipolar drug. The most dangerous side effect is a rash, which can be fatal, so watch for it and tell your doctor immediately (don't panic - it is rare).
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