Several classes of medications are commonly used to manage bipolar disorder, each targeting different aspects of the condition:
Mood Stabilizers
These are the cornerstone of bipolar disorder treatment and include medications like lithium, valproate (Depakote), and carbamazepine (Tegretol), and lamotrigine (Lamictal). Mood stabilizers help to control mood swings, especially manic and hypomanic episodes. Most importantly, mood stabilizers work to prevent future mood episodes and can improve the overall course of illness.
- Lithium: One of the most effective mood stabilizers, lithium has been used for decades to treat bipolar disorder. It is particularly effective in reducing the risk of suicide in individuals with bipolar disorder. Providers at Empire State Psychiatry have nationwide expertise using Lithium safely at therapeutic doses.
- Valproate: Another widely used mood stabilizer, valproate is often preferred in cases where lithium is not effective or not well-tolerated. It is particularly useful in treating rapid cycling bipolar disorder and mixed episodes.
- Carbamazepine: Carbamazepine is an effective medication for preventing mood episodes. One of the main benefits of carbamazepine is that it is unlikely to cause any appreciable weight gain in most patients.
- Lamotrigine: Lamotrigine is a widely used and effective medication to stabilize mood and prevent mood episodes. It is tolerated very well and often patients will have no side effects whatsoever with the medication. Lamotrigine has a very specific titration schedule. Empire State Psychiatry has expertise in safely using Lamotrigine in combination with other medications.
Antipsychotic Medications
Atypical antipsychotics, such as quetiapine (Seroquel), olanzapine (Zyprexa), and risperidone (Risperdal), are often used either alone or in combination with mood stabilizers to treat manic or mixed episodes. They may also help manage depression in bipolar disorder.
Antidepressants
While antidepressants may be used to treat depressive episodes in bipolar disorder, they are typically prescribed with great caution. This is because antidepressants can sometimes trigger manic or hypomanic episodes if not used in conjunction with a mood stabilizer.
Anticonvulsants
Besides their primary use in treating seizures, some anticonvulsant medications like lamotrigine (Lamictal) and valproate are effective mood stabilizers, particularly in treating depressive episodes in bipolar disorder.
Benzodiazepines
These are sometimes used in the short term to manage acute anxiety or agitation associated with manic episodes. However, they are not typically used long-term due to the risk of dependency.
