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Medication plays a key role in treating patients with bipolar disorder, both when immediate intervention is required as well as over the longer term.  This article analyses four of the most popular prescribed drugs for dealing with bipolar disorder across both manic and depressive stages.

Lithobid (Lithium)

Lithium is often chosen as a first line of treatment when it comes to bipolar disorder.  It is an effective mood stabilizer for those in a manic phase, and studies have shown that patients taking lithium compounds are less likely to commit suicide.  Lithium is effective as a treatment as, as well as managing mania, it can also help to manage and prevent depressive episodes.

As these drugs are salt based, careful monitoring of dosage is required, as too little can have no impact, while too much can lead to severe and dangerous side effects, including high blood pressure.  If you have an underlying health condition such as a heart problem, or already suffer from high blood pressure, then Lithobid will not be prescribed.  As there is such little room for error, if you are prescribed Lithobid or another lithium based drug, expect to have your blood tested on a weekly basis.  Lithium can take up to a month to have an effect, so while it is used as a ‘first line’ treatment, it would not be given to patients in need of immediate medical intervention.

Side effects of Lithobid and lithium based drugs include feeling lethargic and weak, lack of coordination, mild nausea and vomiting, and the possibility of thinning hair.

Some lithium-based products are available without a doctor’s prescription, and from a number of nutritional stores under a variety of brand names.  However, these are weaker than the medications available from a doctor, and there is no evidence that they have a lasting effect on symptoms of mania.

Carbamazepine (CBZ)

Although there are still studies being carried out into the effectiveness of CBZ, it is widely accepted that it is as safe and effective as lithium when it comes to treating bipolar disorder.  That said, CBZ may, at times, be given alongside lithium, rather than as an out and out alternative.  An anticonvulsant, CBZ is widely prescribed for patients with ADHD, PTSD, and schizophrenia.  This is because CBZ has high ‘drug interaction’ potential, and has been shown to magnify the impact of certain medications.

At this stage, there are not known to be any underlying medical conditions that would lead to CBZ not being prescribed.  However, it would not be given to pregnant women, as there is strong evidence that taking this drug can lead to birth defects such as cleft palate and cardiovascular development problems.

Side effects of CBZ include dizziness and drowsiness, mild nausea, vomiting, and headaches, as well as a dry mouth and potential lack of coordination.

If you take CBZ, you must stick to your medication, and report any ill effects to a doctor, as withdrawing from the drug yourself leaves you at vastly increased risk of suffering a seizure.

Risperidone (Risperdal)

Risperdal is an antipsychotic drug that will be often be administered to those who require instant medical intervention, as it contains powerful ingredients that act quickly to rebalance chemicals in the brain, potentially lifesaving for those that are experiencing severe manic episodes.  At the same time, Risperdal may be prescribed as a long-term treatment, and has less potential for severe side effects than Lithobid and CBZ.  Importantly, Risperdal also works well in conjunction with antidepressants, meaning it is likely to be given if patients experience manic and depressive episodes in equal measure.

Patients who have a history of heart conditions, blood pressure problems, or issues with liver and kidney functions will not be given Risperdal.

The side effects experienced by taking Risperdal may include increased appetite and weight gain, feeling extremes of hot and cold (for this reason it is crucial you keep yourself hydrated), drowsiness, nausea, and a mild rash across the skin.

Fluoxetine (Prozac)

Patients suffering from bipolar disorder will always be prescribed an antidepressant in conjunction with other medication.  In severe cases of bipolar disorder where Prozac and other medications have not had an impact on depressive episodes, it may be given in conjunction with another antidepressant, Zyprexa (olanzapine).  There is an extensive list of drugs you should not take with Prozac, and you should cover this with your doctor after initial diagnosis.

Prozac is a well-known drug for treating depression as a standalone condition, and as such is a popular choice among physicians for dealing with bipolar disorder.

Strong evidence is present that antidepressants can cause suicidal thoughts, especially in the early stages of taking a drug and in people under the age of 25.  As such, you will be monitored particularly closely over the first three to four months when you begin to take Prozac.

Prozac will not be given to you if you have a history of heart, liver, or kidney problems, as well as diabetes or epilepsy.  Prozac has been shown to trigger changes in a persons’ chemical brain balance after prolonged use of up to a year, although it may be recommended that the drug is taken in smaller doses indefinitely in order to manage any depressive episodes in future.

Side effects of Prozac can include continuing cold and flu symptoms, insomnia, weight gain, mild nausea and dizziness, and a reduction in sex drive.

Moving Forward

All of the medications we have explored here are widely used in the treatment of bipolar disorder, and are likely to be discussed with you should you be diagnosed with the condition.

Have you been diagnosed with bipolar disorder and are currently taking one of the medications listed, or have you had to change because they did not work out?

Share your story with us in the comments section below.