Bipolar medications

I hope you have found the right bipolar medications for you! When I was first diagnosed with bipolar disorder it took a long time for me to fine tune my own bipolar meds.

Bipolar medications require expert prescribing skills and are essential if you really have bipolar disorder

Not all bipolar medications are created equal, and finding the right bipolar drugs for YOU may be a long and difficult journey.

Here at Bipolar-Lives.com we have had our own struggles with bipolar drugs.

We understand the challenges involved in finding - and fine-tuning - the bipolar disorder medications that are best for YOU.

We have also taken the journey and understand how difficult it can be to get the right bipolar drugs.

Don't worry - you are NOT alone! Get the facts from someone who has tried just about all the bipolar drugs out there.

Someone who understands the REAL impact of side effects, medical expenses, and the struggle to communicate with friends, family, and doctors.

My quest for the right bipolar drugs was shorter than it is for many people, but it was still too long. I tried atypical antipsychotics (Geodon was especially disastrous, also Topamax and Depakote - a side effect nightmare) before "coming home" to lithium.

I have family members using the Lamictal and lithium combination and can see why some experts consider this to be emerging as the new gold standard in bipolar medications.

Best Bipolar Drugs?

Reminder

All of my research and experience shows that the primary goal of bipolar medication MUST be mood stabilization.

Bipolar disorder is characterized by mood swings.

Therefore, the best bipolar disorder medications are mood stabilizers.

Mood stabilizers are bipolar drugs that regulate mood swings so that extremes of depression and mania no longer occur.

IMPORTANT:

Many of the most prescribed bipolar medications today are NOT mood stabilizers.

Instead they address ONLY depression OR ONLY mania. Some may even TRIGGER mania or depression.

The most challenging aspect can be finding the right bipolar drug for the current phase of the illness.

For example, there may be a difference between what meds are required for treating an acute mood episode, versus what is required for maintenance treatment.

Further, episodes of depression may require different treatment to episodes of mania. Often this is done through the use of "medication cocktails" - combinations of mood stabilizers with other bipolar approved medications such as certain antidepressants and/or anti-psychotics.

Lithium is the most researched of all bipolar disorder treatments. Research indicates it is best for prevention of mania - BUT lithium is now known to be a WEAK treatment for bipolar depression. (Important as usually we spend much more time in depression than in mania.)

On the other hand, Lamictal is VERY EFFECTIVE for the treatment of bipolar depression. Hence, a potentially effective maintenance treatment for someone with bipolar disorder and a depressive bent would be the Lamictal/Lithium combination.

In fact, the lithium/Lamictal combo is emerging as a new gold standard for controlling bipolar symptoms and bipolar behavior.

The purpose of medications for bipolar disorder

Bipolar medications are often used in combination, for example lithium and Lamictal.

Although some other medication treatments are available and come in and out of fashion, in this section our major focus will be on mood stabilizing bipolar drugs as the first line treatment for bipolar symptoms.

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 medication:

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 - (i.e. 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 medications 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 exhibiting severe bipolar symptoms, you need to return to a balanced mood ASAP.

These factors suggest that the traditional approach of using a proven mood stabilizer such as lithium is still the wisest approach.

(If you are resistant to the idea of mood stabilizers, check out an authoritative source on bipolar medications such as this Practice Guideline for the Treatment of Patients With Bipolar Disorder.)

Bipolar 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 their 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 until you have tried the traditional frontline bipolar medications such as mood stabilizers and anti-convulsant drugs (see bottom of page). An exception is Seroquel (quetiapine), which has a great track record, although some people do gain weight on it. Zyprexa (olanzapine) is to avoided - it can lead to substantial weight gain and diabetes.

Although these drugs have recently become 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. Zyprexa is the biggest culprit.

Abilify is popular because some believe it does not have these same weight gain problems (although it does) and there is an now evidence to support its effectiveness for treating both mixed episodes and bipolar mania.

However, the latest atypical on the market - Latuda - has much milder weight gain side effects, and is both unusual and very welcome in that it is FDA approved for treating bipolar depression.

YOUR Bipolar Medications

Use this section of the website to discover the truth about YOUR bipolar medications.

Learn the facts you need to discuss medication with your medical team and loved ones.

Discover the secrets to:

1. Managing side effects, especially WEIGHT GAIN by using the bipolar diet

2. Understanding the intricacies of medication combinations and how to adjust them according to whether you are stable, manic, or depressed, and

3. STABILIZING instead of over-sedating or over-stimulating.

We will be looking at:

1. Lithium (the classic mood stabilizer)

2. Depakote (mood stabilizer/anticonvulsant)

3. Abilify (atypical anti-psychotic)

4. Geodon (atypical anti-psychotic)

5. Lamictal (mood stabilizer / anticonvulsant)

6. Latuda (atypical antipsychotic)

7. Seroquel (atypical anti-psychotic)

8. Topamax (an anticonvulsant)

9. The benefits of Wellbutrin (an antidepressant)

10. Zyprexa (atypical anti-psychotic).

Remember: bipolar medication is NOT the be all and end all of bipolar treatment options!

Bipolar medications and weight

Bipolar meds and weight

Latuda has come on the market since this table was created. Although it does have weight gain as a side effect, this is much milder than for Seroquel or Zyprexa. Latuda is for treating bipolar depression - not mania or for ongoing maintenance so is probably best as an add-on to lithium or Depakote.

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Related: Bipolar Treatments  |  Medications for Bipolar Depression

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