Table of Contents
Treatment
Bipolar disorder is a recurrent disease that can be unpredictable. It is treatable, however, and many patients go to have healthy and productive lives. The major goals of treatment are to:
- Treat and reduce the severity of acute episodes of mania or depression when they occur
- Reduce the frequency of episodes
- Avoid cycling from one phase to another
- Help the patient function as well as possible between episodes
The doctor will first try to determine what may have triggered the attack and identify any accompanying medical or emotional problems that might interfere with or complicate treatment.
Challenges of Bipolar Treatment
The treatments for bipolar disorder, while very effective, pose some specific challenges for the patient:
- Mood variations in bipolar disorder are not predictable, so it is sometimes difficult to tell if a patient is responding to treatment or naturally emerging from a bipolar phase.
- A patient with bipolar disorder cannot always reliably inform the doctor about the state of the illness.
- The patient is likely to need more than one medication during the course of the disease. This increases the risk for distressing side effects. Noncompliance is common.
- Patients often have more than one medical problem and need different drugs to treat each condition. Such medications may interact with drugs used to treat bipolar disorder or increase side effects. For example, children with bipolar disorder have a higher risk for attention deficit-hyperactivity disorder, which is treated with stimulants that can complicate bipolar treatment.
- Treatment strategies for children and the elderly have not been intensively studied and have not been clearly defined.
- Patients need to monitor their condition on a lifelong basis.
Specific Drugs and Other Treatments Used in Bipolar Disorder
The following are the treatment options for most patients with bipolar disorder, depending on the bipolar disorder phase or episode. Patients should understand that, even with aggressive therapy, either mania or depression recurs in about 75% of patients.
Drugs Used in Bipolar Disorder. Mood stabilizing drugs are the mainstay for patients with bipolar disorder. They are defined as drugs that are effective for acute episodes of mania and depression and that can be used for maintenance. The standard first-line mood stabilizers are lithium and valproate. Both drugs stimulate the release of the neurotransmitter glutamate, although they appear to work through different mechanisms. Other drugs may also be used. Drugs to treat bipolar disorder should be prescribed and managed by a psychiatrist.
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Review Date: 01/28/2011
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine,
Harvard Medical School; Physician, Massachusetts General Hospital.
Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M.,
Inc.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)
