Bipolar disorder is a medical concern that may cause unusual fluctuations in one’s behavior, mood, and activity. A person with bipolar depression can feel extreme ups and downs. This article will define bipolar disorder and discuss the Best Medication for Bipolar Disorder.
What Is Bipolar Disorder?
Bipolar disorder is a mentally associated condition in which a person experiences abnormally extreme changes in mood and behavior. The episodic change will be seen in every action, like sleep pattern, energy level, work, personal relations, focus, and many different aspects of life. The onset is usually in the early twenties, regardless of gender, race, and ethnicity.
It usually has two episodes; a manic episode, in which a person may have impulsive behavior and feel very high and energetic.
And a depressive episode, in which a person may have feelings of hopelessness, full of anxiety, and sometimes potential feelings of suicide.
It is also referred to as “hypomania” if a person has a mild and acute condition and “mania” if a person has a severe and chronic complaint of bipolar depression.
The cause of bipolar disorder is still a mystery, but it is strongly heritable (about 70%). The signs of bipolar disorder are:
- Feeling hopeless and sad
- Change in sleep pattern
- Focus and memory problems
- Suicidal thoughts
- Irritability
- No motivation
- Restlessness
- Delusions and Hallucinations
Is There A Cure For Bipolar Disorder?
Yes, it is curable, but bipolar disorder is lifelong, so treatment will also be lifelong. Treatment consists of psychotherapy, medications, electroconvulsive therapy (ECT), and cognitive behavioral therapy (CBT). But this article will only cover the best medicines for bipolar disorder.
What Are The Best Medications for Bipolar Disorder?
Several types and classes of drugs are considered as Best Medication for Bipolar Disorder that can effectively and safely manage this mental condition.
1- Lithium
Lithium carbonate is the first choice to treat bipolar disorder. It’s a kind of mood stabilizer. Its mechanism is still unknown, but it’s believed to be very effective for depressive and manic episodes. Studies show lithium can decrease suicidal thoughts and future depressive and manic episodes. It is also beneficial to treat acute mania (hypomania) and in combination with tricyclic antidepressants as an adjuvant treatment for resistant depression.
Lithium although is one of the Best Medication for Bipolar Disorder but it takes time to start working, so an individual should keep on taking it for a long time every day. Capsules, pills, and liquid versions are all available. The daily dose of lithium is usually 900 to 1800 gm/day.
Although lithium carbonate is very effective in treating bipolar disorder, it also has adverse effects. For example,
- Nausea and vomiting
- Feeling thirsty
- Tremors
- Convulsions
- Increased urination
- Weight gain
- Cognitive impairment
- Diarrhea
- Shortness of breath
- Hallucinations
Caution
Do not use lithium if you are allergic to it or pregnant because it can cause harm to your fetus. If you have ever had kidney or heart problems, thyroid disorders, cancer, or epilepsy, or you are a lactating woman, do inform your doctor first about these. Always use it per your GP’s advice, as overdosing can cause lithium toxicity, leading to serious health problems and eventually death. Lithium can also interact with many drugs like NSAIDs (non-steroidal anti-inflammatory drugs), ARBs (angiotensin II receptor blockers), ACE inhibitors (angiotensin-converting enzyme), and calcium channel blockers and cause lithium toxicity.
You can avoid lithium toxicity by staying hydrated and using an average amount of salt in your diet because these two things affect the lithium level in your blood.
2- Atypical Antipsychotic Medication
Antipsychotic medications are usually used to treat schizophrenia, but second-generation atypical antipsychotic drugs can also be used to treat bipolar disorder and depression. They are mainly used to treat manic or mixed episodes (both manic and depressive).
Some frequently prescribed atypical antipsychotic drugs are:
- Risperidone (Risperdal)
- Olanzapine (Zyprexa)
- Asenapine (Saphris)
- Quetiapine (Seroquel)
- Ziprasidone (Geodon)
- Aripiprazole (Abilify)
Side effects may include shaking, increased appetite, weight gain, salivation, sedation, and constipation.
3-Anticonvulsant Medications
Anticonvulsant medications are used to treat seizures, but they can also be frequently used as mood stabilizers to manage bipolar disorder. It is also the first choice, just like lithium, because lithium can be less tolerated and effective for some people. Then this is a good option. The anticonvulsant works more speedily than lithium to show its effectiveness.
The most commonly prescribed anticonvulsant drugs are:
- Valproic acid (Depakene)
- Lamotrigine (Lamictal)
- Carbamazepine (Equetro)
- Trileptal (Oxcarbazepine)
- Topiramate (Topamax)
Side effects may include drowsiness, blurred vision, low WBC and platelet counts, skin rashes, and nausea.
Topiramate can cause cognitive impairment, kidney stones, and weight loss.
4-Antidepressant Medications
Antidepressants can also be considered for the management of bipolar disorder. If a person is taking antidepressants, they also need mood stabilizers to avoid mania. For this, a drug called olanzapine/fluoxetine (Symbyax) is available, which is a combination of an antidepressant (fluoxetine) and an antipsychotic medication (olanzapine).
Different classes of antidepressants are used to manage symptoms of bipolar disorder; some are mentioned below:
Selective Serotonin Reuptake Inhibitors, or SSRIs
- Fluoxetine (Prozac)
- Sertraline (Zoloft)
- Paroxetine (Paxil, Pexeva)
- citalopram (Celexa)
Serotonin And Norepinephrine Reuptake Inhibitors (SNRIs)
- Desvenlafaxine (Pristiq)
- Venlafaxine (Effexor XR)
- Duloxetine (Cymbalta)
Tricyclic Antidepressants (TCAs)
- Imipramine (Tofranil)
- Amitriptyline (Elavil)
- Nortriptyline (Pamelor)
- Clomipramine (Anafranil)
Monoamine Oxidase Inhibitors (MAOIs)
- Tranylcypromine (Parnate)
- Phenelzine (Nardil)
The side effects of antidepressants are dry mouth, insomnia, weight gain, dizziness, and sexual dysfunction.
5-Anti-Anxiety Medications
Anti-Anxiety medications are also used to manage bipolar disorder, but for a short period because long-term use may lead to a higher risk of tolerance and addiction. Some anti-anxiety drugs are mentioned here:
- Benzodiazepines
- Clonazepam (Klonopin
- Lorazepam (Ativan)
Bottom line
The best medication for bipolar disorder is discussed above, but no single drug is used to manage bipolar disorder. It is a variable and lifelong condition, so a long-term treatment plan may help to cope with it. Medication varies from person to person. To overcome this mental condition, you cannot only rely on drugs, but lifestyle modifications such as exercise, quitting smoking, alcohol, and tobacco, maintaining a good sleep pattern, and managing stress are also important.
