Effects of Bipolar Medication

Bipolar disorder is characterized by intense mood swings - people with bipolar have "manic" highs and depressive lows. While there are a variety of medications to ease the symptoms of bipolar, it's important to look at the effectiveness of each medication, as well as possible side effects. According to the National Institute of Mental Health (NIMH), the four main types of drugs used to treat bipolar are mood stabilizers (including Lithium), atypical antipsychotics (including Abilify and Seroquel), serotonin-affecting antidepressants (including Prozac, Zoloft and Wellbutrin) and monoamine oxidase inhibitors (including Elavil).

Mood Stabilizers

• The oldest treatment for bipolar disorder is Lithium. Lithium and anticonvulsant medications are often prescribed first when bipolar disorder is first diagnosed. According to NIMH, "It is often very effective in controlling symptoms of mania and preventing the recurrence of manic and depressive episodes." Possible side effects of Lithium include restlessness, dry mouth, bloating or indigestion, acne, unusual discomfort to cold temperatures, joint or muscle pain, brittle nails or hair, and weight gain. Weight gain from Lithium is due to low thyroid function, or hypothyroidism, which is especially prevalent in women who are taking the drug.

  Anticonvulsant medications commonly used to treat bipolar disorder are Depakote (valproic acid), Lamictal (lamotrigine), Neurontin (gabapentin), Topamax (topiramate) and Trileptal (oxcarbazepine). People who are taking anticonvulsant medications should be monitored closely, because the FDA reports that they may cause suicidal thoughts or behaviors. Additionally, Depakote can cause polycystic ovary syndrome (PCOS) in women under the age of 20. NIMH reports that PCOS can cause obesity, excess body hair and disruptions in the menstrual cycle.

Atypical Antipsychotics

• There are 14 types of atypical antipsychotic medications. Zyprexa (olanzapine) was the first to be FDA-approved for use in bipolar patients. Abilify (aripiprazole), Seroquel (quetiapine), Risperdal (risperidone) and Geodon (ziprasidone) are other atypical antipsychotics that may be prescribed as standalones or in addition to other medications. Side effects from atypical antipsychotics may include drowsiness, dizziness, blurred vision. rapid heartbeat, sensitivity to the sun, skin rashes, menstrual problems and weight gain. NIMH reports, "In rare cases, long-term use of atypical antipsychotic drugs may lead to a condition called tardive dyskinesia (TD)." TD causes involuntary muscle spasms, generally around the mouth.

Selective Serotonin Reuptake Inhibitors (SSRIs)

• SSRIs include Celexa (citalopram), dapoxetine, Lexapro (escitalopram), Prozac (fluoxetine), Luvox (fluvoxamine), Paxil (paroxetine), Zoloft (sertraline) and Zelmid (zimelidine). Side effects from SSRIs include a possible manic outbreak in patients with bipolar, or worsening of manic syptoms, headaches, nausea, insomnia and reduced sex drive.

Monoamine Oxidase Inhibitors (MAOIs)

• There are dozens of MAOIs, but they are generally no longer used in patients with depression or bipolar, or are used as a last resort. MAOIs require a special diet and constant monitoring. They are also more likely to cause side effects that lead to patients halting the drug therapy. The three main drugs currently used to treat bipolar are Nardil (phenelzine), Parnate (tranylcypromine) and Emsam (selegiline). Side effects include insomnia, dizziness, dry mouth, blurred vision. weight gain, high blood pressure, muscle spasms and reduced sex drive.

Talk to Your Doctor

• Each drug has its own specific effects and side effects which may or may not be listed here. Talk to your doctor about possible side effects before you begin any medication. Also ask the following questions: What is the rate of success with this drug in clinical trials with people who have bipolar? When can I expect the drug to start easing my symptoms? What is the rate of people who stop taking this drug due to side effects?