An Overview of Treatments for Bipolar Disorder
Medical and therapeutic treatments for bipolar disorder include antidepressants, mood stabilizers, antipsychotics, benzodiazepines, and psychotherapy. Treatment of bipolar disorder is usually lengthy, often lasting years, although most long-term treatment is limited to simply taking a daily medication to help keep the symptoms of bipolar disorder at bay.
Ideally, the best treatment for bipolar disorder is a combination of different medications, psychotherapy (or talking therapy), natural treatments and lifestyle choices. No single treatment, therapy, or lifestyle choice is likely to be the most effective. A number of them working as complements to each other ensures your best chance of success.
Medication Treatment for Bipolar Disorder
Medication treatment for bipolar disorder generally involves three classes of drugs:
- Antidepressants for depression
- Mood stabilizers for mania
- Anti-psychotics for mania
Some people may also be prescribed a benzodiazepine to help calm them. People with bipolar disorder are typically prescribed a combination of drugs referred to as a “drug cocktail.” The American Psychiatric Association, in its bipolar disorder treatment guideline, lists remission as the goal of medications treatment. Remission is defined as having virtually no symptoms and a return to full functioning. Unfortunately, you may have to settle for less, given the imperfect nature of these medications. However, you are entitled to a best effort from our psychiatrist. Equally as important, side effects that interfere with your ability to think and function should not be regarded as an acceptable trade-off for reducing your symptoms.
What you need to know about antidepressants from a bipolar perspective is that there is divided opinion in psychiatry concerning the safety of bipolar patients on antidepressants. This is because an antidepressant without a concomitant antimania medication is almost certain to switch a patient into mania. Some authorities contend that even with an antimania drug, the danger is there. Accordingly, the American Psychiatric Association, in its bipolar disorder guidelines issued in 2002, does not recommend an antidepressant-antimania combination as a first option. Another guideline recommends tapering and discontinuing soon after remission is achieved.
On the other hand, there is a smaller body of opinion that feels the risk is overstated. One study found that those who stayed on their antidepressants fared better over 12 months than those who quit them before six months. But the same study also found that antidepressants did not work for the large majority of those in the study.