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Medications Used to Treat Bipolar Disorder Level 2

Bipolar II, or bipolar disorder level 2, is characterized by a major depressive state with brief periods of hypomania. Hypomania is a less severe form of mania, typically involving bursts of energy, increased anxiety and insomnia. Those suffering from bipolar II rarely experience true manic states. Medications used to treat bipolar disorder level 2 include many of the same medications used to treat the more traditional bipolar I disorder.

  1. Mood Stabilizers

    • Lithium is the traditional mood stabilizer treatment for bipolar disorders, including bipolar II. According to Dr. Daniel Smith in an article featured in Current Psychology, "Lithium has the most supporting evidence, showing efficacy for all 3 phases of BP II." Lithium's exact method of action is unknown but it decreases the severity of both the depressive and manic (or hypomanic) phases and reduces the number of emotional shifts.

      Some anti-convulsive medications also exert a mood-stabilizing effect. According to the National Institute of Mental Health (NIMH), valproate (Depakote) and lamotrigine (Lamictal) are effective at managing manic phases and depressive episodes. Other anti-convulsives such as gabapentin (Neurontin), topiramate (Topamax) and oxcarbazepine (Trileptal) are also sometimes prescribed but as of 2008, the NIMH reports that "no large studies have shown these medications to be any more effective than other mood stabilizers."

    Atypical Anti-Psychotics

    • Newer, or atypical anti-psychotics, may be added to a treatment plan to help control the symptoms of hypomania in the case of bipolar II disorder. Olanzapine (Zyprexa), quetiapine (Seroquel), and aripiprazole (Abilify) are the more common anti-psychotics prescribed. These medications can cause a shift toward slower thinking and a more depressed state. Therefore, their use in bipolar level 2 disorder is typically reserved for those who experience more severe hypomanic states.

    Antidepressants

    • Antidepressants often are used in the treatment of bipolar II. Since bipolar II often is misdiagnosed as depression, antidepressants may be the first medications prescribed. Once bipolar II has been diagnosed, antidepressants often are added to mood-stabilizing medication regimes to help control depressive symptoms. However, a large NIMH study found that "for many people, adding an antidepressant to a mood stabilizer is no more effective in treating the depression than using only a mood stabilizer." The use of antidepressants in the treatment of bipolar disorders remains controversial because of the risk for rebound manic phases, rapid cycling from one phase to another, mixing of the two states, and increased suicide risks.

    Cautions

    • As with many forms of depression and bipolar disorders, treating bipolar II with medications may increase the risk of suicide. This is because as the depression improves, the patient has more energy and is better able to carry out any suicide plans they already might have had in place. Notify your physician immediately if you become preoccupied with death or develop thoughts of suicide.

      As always, consult your psychiatrist or medical physician before following any medical advice.

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