Bipolar Medications: Understanding Your Options
Bipolar disorder has the potential to wreak havoc on your life when it’s not treated. Medications are one of the most important treatments for anyone diagnosed with bipolar disorder. Finding the right bipolar medication can make all the difference. Here is a list of bipolar medications.
Mood Stabilizers
Mood stabilizer drugs help prevent the highs (mania) and lows (depression) associated with bipolar disorder. Let’s take a closer look at some of the most common mood stabilizers for bipolar disorder.
Lithium
Lithium (Lithobid, Eskalith) is one of the most widely studied medications for bipolar. It’s been used since the 1970s. Lithium is very effective for controlling the symptoms of active mania. Lithium can also help prevent the recurrence of mania and depression. It also significantly helps reduce suicidal thoughts and behavior in people with bipolar.
Lithium can affect thyroid and kidney functioning. Therefore, close monitoring and frequent blood work is required for anyone taking lithium.
Divalproex Sodium (Depakote)
Depakote is an anticonvulsant that is approved by the Food and Drug Administration (FDA) to treat manic or mixed episodes in people with bipolar disorder. Depakote increases levels of the neurotransmitter GABA in the brain, which helps reduce manic and mixed episode symptoms.
Lamotrigine (Lamictal)
Lamotrigine is an anticonvulsant medication approved by the FDA to treat bipolar disorder. It’s especially helpful for bipolar depression. However, in clinical studies, it has little to no effect on mania. So, people with bipolar 1 may need another medication to treat manic episodes.
Antipsychotics
Antipsychotic medications may be used in bipolar disorder to treat or prevent acute mania. They are also used as mood stabilizers for bipolar and for psychotic symptoms. Common antipsychotics for bipolar 1 and 2 include:
Second-Generation Antipsychotics (SGAs) - These include aripiprazole (Abilify), olanzapine (Zyprexa), asenapine (Saphris), Latuda (lurasidone), ziprasidone (Geodon), lumateperone (Caplyta), and paliperidone (Invega). These are newer medications. SGAs generally have fewer side effects compared to older antipsychotics.
First Generation Antipsychotics (FGAs) - Examples of FGAs include Haloperidol (Haldol) and Chlorpromazine (Thorazine). These antipsychotics are very effective for mania and psychosis. FGAs typically have a faster onset of action compared to SGAs. For this reason, they are often used as a bipolar anger medication to quickly control severe agitation, mania, or psychosis. However, FGAs can cause significant side effects.
Benzodiazepines
Doctors may prescribe benzodiazepines to help during severe manic or psychotic episodes. The Benzodiazepines used most often in bipolar treatment include clonazepam (Klonopin), lorazepam (Ativan), alprazolam (Xanax), diazepam (Valium).
Benzodiazepines can help with bipolar 1 mania symptoms. These drugs can also help with sleep. Research shows that benzos may halt the progression of insomnia into mania in bipolar 1 patients. Additionally, benzodiazepines are first-line treatments for catatonia, which can sometimes occur with bipolar disorder.
Learn more about catatonia.
These medications do have the risk of tolerance and dependence. They carry an FDA black box warning for this. For this reason, it’s important to use these medications exactly as prescribed.
Bipolar Medication Tips
If you have bipolar disorder, medication will likely be a part of your daily routine. To find the best med regimen for you, work with your psychiatrist or prescriber. You may need to try several different mood stabilizers before you find the right one for you.
What Are the Best Medications for Bipolar Disorder?
There isn’t one magic medication that will completely ease the symptoms of bipolar disorder. Usually, a combination of treatments will be needed. It also depends on whether you have bipolar 1, which presents with mania, or bipolar 2, which is characterized by hypomania and bipolar depression.
Bipolar Depression
Lithium and other mood stabilizer drugs can help prevent and treat bipolar depression. FDA-approved drugs used for bipolar depression include:
Quetiapine (Seroquel)
lumateperone (Caplyta)
Lurasidone (Latuda)
Mania
Besides lithium, antipsychotic medications are most often used to help with symptoms of mania. Bipolar meds for mania include cariprazine (Vraylar), aripiprazole (Abilify), ziprasidone (Geodon), quetiapine (Seroquel), and olanzapine (Zyprexa). The anti-seizure drugs divalproex sodium (Depakote) and valproate are also approved for mania.
Bipolar Medication FAQs
Here are some of the most frequently asked questions that people have about bipolar meds.
Are There Any New Bipolar Medications?
Yes, there are several new medications for bipolar disorder, including:
Caplyta (lumateperone) - This is a bipolar antipsychotic medication. It’s used to treat bipolar I and bipolar II depression.
Lybalvi (olanzapine/samidorphan) - This bipolar medication is used to treat manic or mixed episodes that happen with bipolar 1 disorder,
Do Bipolar Meds Have Side Effects?
Yes, all medications carry the risk of side effects, including the ones used to treat bipolar disorder. Side effects vary depending on the medication. It’s important to talk to your doctor if you are experiencing side effects.
