Medications Used to Treat Bipolar Disorder

Bipolar disorder, also called, manic depressive illness, is an uncomfortable diagnosis to live with. But there is an array of medications that can help patients live and live well with this disease, if they are willing to go to a psychiatrist or a clinic, take the medication offered and use a chart to detail side-effects of the medicine.

History of Manic-Depression or Bipolar Disease

• Years ago when people suffered from bipolar disease, they often didn't know what it was or if it was anything to worry about. They thought they just didn't feel very good. They might experience bursts of anger, depression, violence or mania. But it was very often the people living with and perhaps loving them who knew something was terribly wrong. The first person to use the term "manic-depressive illness" was a German psychiatrist Emil Kraepelin in the late1900s. Then, in 1947, another German psychiatrist, Karl Leonhard, divided that classification into unipolar (the depression part of the equation) and bipolar (mania coupled with depression).

What Does It Mean to Be Bipolar?

• People who suffer from manic depression are believed to have a brain disorder that creates extreme shifts in their moods and energy levels. The changes can be hardly noticeable or extremely dramatic, but the result for that person is usually broken relationships, unsuccessful work experiences, poor performance in school, and in some severe cases, suicide. It is considered a life-long condition that comes and goes and can last from days to years. The National Alliance on Mental Health (NAMI) estimates that there are 10 million Americans suffering from this disease and that it strikes men and women equally. For many people, the disease can show up in adolescence or even in childhood. Most often it makes its appearance early in an adult's life.

Symptoms of Bipolar Disease

• Feelings of depression coupled with hopelessness are often part of the of the bipolar patient's symptoms. These can be accompanied by thoughts of suicide, changes in the sleep pattern and loss of interest in activities that once provided pleasure. But when those periods of depression are punctuated by episodes of mania, or emotional highs, that's the full-blown description of bipolar disease. Many people with this disease get hooked on the "highs" because it often makes them feel euphoric, with increased energy and racing thoughts. But there is a downside to all this in that the "highs" may lead to inappropriate behavior, restlessness, trouble with concentration and a decision that there's no need for sleep. One of the biggest problems for bipolar sufferers in a manic episode is that they may seem extremely irritable and have an inflated opinion of their own powers, which is bound to get them into trouble with the rest of the world.

First-Line Medications Used to Help Bipolar Disorder

• There are many medications that doctors use to help the bipolar patient. The problem is that not every medicine helps everyone who suffers from this disorder. So many times a patient must go through a trial period with a number of pills, which may or may not work, and may create unwanted side effects too uncomfortable to stay with. Some patients decide to live with their spiraling moods rather than go through the process of finding something that would help them. Among the tried and true medications that often work for bipolar patients, are lithium and Depakote, but there are other, newer medicines as well.

  1. Lithium (Eskalith, Cibalith-S, Lithobid) a natural salt. Lithium carbonate, citrate and orotate are all mood stabilizers and are considered extremely effective for both mania and depression.

  2. Depakote (Valproic acid, Divalproex Sodium) by Abbott Laboratories. Approved in 1995, this is one of the newer drugs recommended for bipolar disorder. It is an anti-convulsant and is often used when people have what's called rapid-cycling mood disorders.

  3. Tegretol (Carbamazepine), Lamictal (lamotrigine), Neurontin * gabapentin) and Topamax (topiramate) These are considered adjunctive medications that are often prescribed for a short-term mania episode.

  4. Many people suffering from bipolar disorder wind up taking what is known as "a cocktail" of medicines. The only problem with that is if the patient stops taking one or more of the mixture, and perhaps just the antidepressant is taken and the mood stabilizer is not, there is a danger that the patient may go into a full-blown manic episode.

  5. If the bipolar patient exhibits signs of psychosis, meaning he or she is not in touch with reality, doctors today can try adding an antipsychotic medication to the cocktail. These are also called "off-label" pills. Clozaril (clozapine) was introduced in this country in 1990. Later came Risperdal (risperidone), Zyprexa (olanzapine), Seroquel (quetiapine), Geodon (ziprasidone) and the newest one, Abilify (aripiprazole). A doctor can prescribe any of these drugs to be used in conjunction with the more targeted drugs for bipolar, like lithium and Depakote.

Other Medications That Can Help Bipolar Patients

• The medical community, in its quest to find help for the bipolar sufferer, has come up with some alternative medicines that are often used to treat another illness. One of these is Calcium Channel Blockers, which are normally used to regulate the blood pressure in patients with heart problems. It is believed they can also help to stabilize a person's moods. The list includes:
  * Diltiazem
  * Nifedipine
  * Nimodipine
  * Verapamil

  Benzodiazepines, which help to ease nervousness and tension by slowing down the central nervous system, also slow brain activity. Because of that, they help to treat the mania part of bipolar disorder, and its accompanying panic and insomnia. Here are some medicines that are used for bipolar patients:
  * Ativan (lorazepam)
  * Klonopin (clonazepam)
  * Valium (diazepam)
  * Xanax (alprazolam)

  There are also some newer "atypical" antidepressants. But they are not approved by the FDA to treat bipolar depression. Doctors say they seem to play a role in treating it. These include:
  * Wellbutrin ( bupropion)
  * Effexor (venlafaxine)
  * Remeron (mirtazapine)
  * Serzone (nefazodone)
  * Prozac (fluorextine)

More Extreme Help for the Bipolar Sufferer

• Many of us think of electroconvulsive therapy (ECT), also known as electroshock therapy, as a torturous, painful procedure used in movies of the 1940s to either punish or sedate a patient. But ECT is still used in extreme cases for bipolar patients who are hospitalized and might be considering suicide, are dangerous to other patients, or psychotic. Doctors say it is effective in nearly 75% of the patients who have it.

  These days, ECT is usually used as a procedure of last resort, when the patient fails to respond to medication or therapy. And the patient is well taken care of. He or she is given a muscle relaxant and goes under general anesthesia to minimize the effects.

Bipolar Medication Side Effects

• One of the most difficult aspects of having bipolar disorder is finding the right mixture of medications to stabilize the illness. It's kind of like a Chinese menu. Your doctor may choose one medicine from column A, let's say a mood stabilizer, one from column B, maybe an anti-depressant, and another from column C, an anticonvulsant.

  But taking just one of these medicines can result in unwanted side effects. Taking all three could be unpleasant at best. All or any of these medicines may trigger diabetes or hyperglycemia, make your mouth dry, make you sweat or make you break out in hives. One disappointing side effect is that most make you gain weight and put a damper on sexual performance. They can also result in constipation or blurred vision.

  The important thing when first taking these medications is to keep a journal of how you are reacting and discuss it with your doctor. He or she can then cut back on the dosage or maybe stop the medication and try something else. The problem is that many people who suffer from bipolar disorder get disturbed when they first take medicines because of the side effects. But if they can hang in there and discuss the problem with a doctor, it should eventually work out well.