The Beginners Guide To Bipolar Medication
Researchers are continuously looking into new medications to better treat bipolar. But for now, here are the major players:
Medications for bipolar disorder target two types of chemical messengers in the brain: neurotransmitters and neuromodulators. Some meds primarily control mania, while others treat depression. Sometimes one medication works; at times multiple prescriptions are necessary.
You may need to try several kinds of medication, in different doses, before figuring out the right approach—and that can take time. But working closely with their prescribing doctor, people generally find something that works for them.
Research continues into developing new medications, with a focus on better understanding the mechanisms underlying bipolar disorder, but for now, these are the major players:
#1 Mood stabilizers
Mood stabilizers moderate both the highs (hypo/mania) and lows (depression) of bipolar. This class includes lithium, a naturally occurring salt that remains a primary first-line treatment for bipolar.
Anticonvulsants regulate mood swings, possibly by calming hyperactivity in the brain, and are often prescribed to treat frequently recurring mood episodes.
#3 Atypical antipsychotics
Atypical antipsychotics, also called second-generation antipsychotics, are generally prescribed to treat manic symptoms and hallucinations, delusions, or other psychotic symptoms. There are newer formulations approved for bipolar depression and mood episodes with mixed features (co-occurring depressive and manic symptoms) as well. Atypical antipsychotics are generally considered an advance on first-generation, or typical, antipsychotics, because they tend to have fewer side effects.
Antidepressants should be paired with a mood stabilizer—if prescribed at all—when treating bipolar depression.
Printed as “Making peace with Meds,” Winter 2018