Bipolar disorder, a psychiatric disorder characterized by bouts of depression and mania (extreme euphoria), can range from being a mild to severe condition. While milder cases of bipolar disorder may go untreated for years due to difficulty diagnosing this condition, serious cases of bipolar disorder are marked by recurring dramatic mood swings that make it easier for doctors to diagnose.
If you suspect that you or someone you know suffers from bipolar disorder, seeking medical attention for a proper diagnosis is important to getting treatment that can restore normalcy to a patient’s life. In extreme forms, bipolar disorder that is left untreated can make patients self-destructive and potentially suicidal.
Bipolar Disorder Medications
Because no cure for bipolar disorder exists at this time, treatments revolve around minimizing the symptoms, namely balancing the patient’s moods and preventing dramatic mood swings. Along with getting therapy, common bipolar treatments include one or a combination of the following medications:
- anticonvulsants: carbamazepine, lamotrigine
- anti-psychotics: chloropromazine, thioridazine and the newest, highly effective olanzapine
- mood stabilizers: lithium, sodium vaoproate.
While mood stabilizers are effective when a person experiences a period of mania, they tend to be impotent during bouts of depression. As a result, some doctors prescribe their bipolar patients antidepressants, especially if the patient is more prone to depressive states.
However, because a few studies have highlighted that antidepressants may end up worsening bipolar disorder, the medical community continues to debate whether or not they should be used in the treatment of this condition.
Also known as antiepileptics, anticonvulsants are a type of medication prescribed to prevent patients from experiencing seizures. While doctors typically prescribe anticonvulsant medication to epileptic patients, they also generally prescribe this medication to those who suffer from bipolar disorder, as anticonvulsants have mood stabilizing properties.
In scientific terms, anticonvulsants stabilize the mood by slowing down the rate at which neurons fire and by blocking:
- AMPA receptors
- calcium channels
- NMDA receptors
- sodium channels.
While anticonvulsants may be used in place of lithium, some doctors prescribe both anticonvulsants and lithium to their bipolar patients. Common drug groups that work as generic anticonvulsants include:
- aromatic allylic alcohols
- valproylamides (specifically valproate).
The Anticonvulsant Valproate
Also used to treat migraines, seizures and epilepsy, valproate (or valproic acid, VPA) is one of the primary anticonvulsants doctors prescribe to treat bipolar disorder. Approved by the FDA in 1995 to treat mania, valproate is, by some doctors, considered to be a better treatment option than lithium because valproate has far less severe side effects. Consequently, patients are more willing to comply with taking their medication and, therefore, experience fewer bouts of mania.
However, while valproate is effective in treating manic episodes with limited side effects, it is largely ineffectual in preventing depressive periods. As a result, some doctors prescribe antidepressants alongside valproate to help patients through depressive phases.
Like valproate, lamotrigine is a type of medication that may be paired with another drug (namely an antipsychotic) to make it most effective. In addition to treating various types of seizures, lamotrigine is a relatively new treatment option for bipolar disorder in that it has recently been proven to be an effective mood stabilizer. Although researchers still haven’t identified the exact ways in which lamotrigine works, some theorize that this drug is a sodium channel blocker.
Some of the biggest benefits of taking lamotrigine include:
- effectiveness in treating bipolar patients who didn’t respond to lithium and/or valproate
- an increased ability to prevent and manage depressive states
- the lack of need to regularly perform blood monitoring tests
- very limited side effects.
Currently, the major downside associated with lamotigine revolves around its side effects. While women are more likely than men to experience lamotigine side effects, all patients are a risk of having them. Potential side effects of lamotigine include:
- dry moth
- muscle aches
- severe rashes (known as Stevens-Johnson syndrome).
Because the long-term affects of lamotigine are still unknown, doctors and patients should weigh the costs and benefits to using this medication in light of individual circumstances.
Bipolar Focus (2007). Bipolar Disorder Medications. Retrieved July 18, 2007 from the Bipolar Focus Web site: http://www.psychologyinfo.com/depression/meds-bipolar.htm.
Psychology Information Online (2007). Medication for Bipolar Disorder. Retrieved July 18, 2007 from the Psychology Information Online Web site: http://www.psychologyinfo.com/depression/meds-bipolar.htm.