1. Bipolar Disorder Slideshow Pictures
2. Bipolar Disorder (Mania) Quiz
3. Depression Slideshow Pictures

Medical Author:

Mara Aloi, MD

Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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A variety of medications are available by prescription. These medications are usually referred to as mood stabilizers. Other classes of medications, including anticonvulsant medications and atypical antipsychotic medications, may also be helpful in treating bipolar disorder.

• Many people start by taking lithium, which has been used for many years to treat bipolar disorder. Yet as many as half of all people with bipolar disorder do not respond to this medication.
• Other possibilities for medical treatment are antiseizure medications that function as mood stabilizers. Antiseizure medicines that are sometimes used to treat bipolar disorder as well include carbamazepine (Tegretol), valproic acid (Depakote), lamotrigine (Lamictal), and oxcarbazepine (Trileptal).
• The atypical antipsychotic medications, including olanzapine (Zyprexa), risperidone (Risperdal), aripiprazole (Abilify), quetiapine (Seroquel), Ziprasidone (Geodon), and Clozapine (Clorazil), used to treat psychosis are sometimes used to treat bipolar disorder; these medications have been shown to be effective for such symptoms.
• All these medications have side effects, and each person with bipolar disorder needs close monitoring for the side effects while taking the medication.
• Antidepressant medication is sometimes taken with a mood-stabilizer medication during depressive episodes. Taking the antidepressant medication alone can trigger mania. There is now a ready-made combination medicine approved for use in bipolar depression, Symbyax, which has the antipsychotic drug, olanzapine, along with the antidepressant, fluoxetine (Prozac), both in one capsule.

The choice of medications is customized for each person.

• Be sure to tell your health care professional about any other medical conditions you have.
• Tell your health care professional about all medications you take, including over-the-counter drugs and herbal preparations. These may interact with the medications used for bipolar disorder. For example, the herbal preparation known as St. John's wort may reduce the effectiveness of some medications. Also, since it is itself an antidepressant, it may trigger a manic episode in a person with BD who is not on another mood stabilizer.
• Women also should discuss any plans for pregnancy and breastfeeding with their health care professional, because a change in medication may be necessary.

Lithium: The exact way lithium works in controlling the mood swings of bipolar disorder is unknown.

• Lithium may take as long as two weeks to take full effect.
• It may have an "anti-suicide effect."
• Levels of the drug must be closely monitored with blood tests.
• Drink plenty of fluids and do not restrict intake of salt while taking lithium because dehydration can cause the level of the drug in the blood to be dangerously high.
• If you have kidney or heart problems, you may be started on another medication instead.
• Most common side effects are thirst, increased urination, diarrhea, nausea, tremors, and dizziness.

Carbamazepine (Tegretol): This medication reduces the excitability of brain cells and helps to control the symptoms of bipolar disorder.

• It is especially good for those who cycle between mania and depression very quickly.
• This drug may be used alone or in combination with another medication.
• Levels of medication and blood cell counts are monitored.
• Do not use this drug if you have a liver or blood disease.
• Do not drink alcohol if you are taking this drug.
• Side effects include dry mouth, constipation, drowsiness, nausea, trouble urinating, and low blood count (rare).

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