Understanding bipolar disorder medication

Bipolar disorder is a serious, chronic mental health condition that involves having extreme mood swings. Someone with bipolar disorder can swing between periods of depression and periods of feeling constantly high, irritable, agitated or excited, which is known as mania or hypomania.

If you have bipolar disorder, treatment can help make the episodes of depression and mania shorter, easier to get through and less likely to happen.

Most people with bipolar disorder are treated with a combination of medication and psychotherapy. Psychological treatment on its own is usually not enough. Medication plays a vital role and is used to:

• treat episodes of depression
• treat episodes of mania or hypomania
• prevent these episodes from happening again

Types of bipolar medication

People with bipolar disorder often need to take a combination of medications. They work by correcting an imbalance in the chemicals in the brain.

Mood stabilisers

Mood stabilisers are medicines that treat or prevent mania by stopping mood swings. They include:

• lithium, which is used as a long-term treatment
• anticonvulsants such as sodium valproate, carbamazepine and lamotrigine

Antipsychotics

Antipsychotics, such as risperidone, quetiapine, olanzapine, asenapine and paliperidone, may be used if there are psychotic symptoms (i.e. hallucinations or delusions). They also help to stabilise mood, treating both mania and depression, and helping reduce the risk of further episodes.

Antidepressants

If you have bipolar disorder and are going through an episode of depression or have suicidal thoughts, your doctor may prescribe antidepressants to help you recover. You will usually still need to be on a mood stabiliser.

Learn more about antidepressant medicines.

You and your doctor will work out which medications work best for you. Sometimes the first one isn’t the right one. It’s important to talk to your doctor and work with them to find the right one, and to take them as prescribed.

Important information about bipolar disorder medication

Bipolar medication can cause side effects in some people.

Side effects of antipsychotic medication include:

• drowsiness
• weight gain
• dry mouth
• problems with sexual function
• low blood pressure
• periods stopping

Side effects of lithium carbonate include:

• shaking
• muscle weakness
• memory problems

Lithium carbonate can be very effective for bipolar disorder, but it can build up in the body and eventually cause harm to the thyroid, kidneys or central nervous system. If you are taking lithium carbonate, you will need regular blood tests to make sure you are taking the right level.

If you have too much lithium, it can be toxic. If this happens, it usually passes from the body about 2 days after you stop the treatment. Contact the doctor who prescribed the medication immediately if you are taking lithium carbonate and you experience:

• nausea
• vomiting
• diarrhea
• tiredness
• difficulty concentrating
• unsteadiness
• increased thirst

For most people, the benefits of treatment outweigh the risks of being on medication. However, if you or someone you know is considering treatment, ask the treating doctor:

• What are the benefits of bipolar disorder medication?
• What are the risks of medication?
• What are the side effects?

Also discuss what other medications are being taken as some medications can interact with bipolar medication. Never discontinue or adjust doses on your own without talking to your doctor.