Bipolar Disorder FAQs - Medications to Treat Bipolar

Written by HealthyPlace.com Staff Writer

7. What medications are used to treat bipolar disorder?

There are a number of medications for the treatment of people with bipolar disorder, among them a group of medications called mood stabilizers. These include lithium and divalproex and possibly some other anticonvulsants and atypical antipsychotic drugs. The therapeutic strategy is to treat acute manic episodes and then continue long-term administration to prevent episode recurrence. These medications seem to be somewhat less effective than antidepressants in treating acute depressive episodes.

Antidepressants may be used in conjunction with a mood-stabilizing drug to pull someone out of a depressive episode. Such antidepressants include the older tricyclic antidepressants, the monoamine oxidase inhibitors and the newer selective serotonin reuptake inhibitors, venlafaxine (Effexor) and buproprion (Wellbutrin). There is some evidence that these new medications are better tolerated than the older antidepressants and may have less risk of precipitating hypomanic or manic episodes.

A manic episode is a discrete, recognizable psychiatric state that is often a medical emergency. It is characterized by severe alterations in mood consisting of euphoria, expansiveness, irritability and, sometimes, severe depression. In addition, people who are manic may have racing thoughts and speak very quickly in an uninterrupted fashion. Their behavior is characterized by increased activity, diminished sleep, a tendency to be distracted, engaging in many activities at once and disorganization.

Mania can occasionally become so severe that it is accompanied by psychotic symptoms such as delusions, hallucinations and very disorganized thinking, similar to schizophrenia. In addition, people in manic episodes can be very impulsive and occasionally violent. Often, unfortunately, they have little insight into their behavior during the throes of an actual manic episode.

9. What is hypomania?

Hypomania is a milder form of mania. Someone who is hypomanic typically is more active and energetic than usual. They may have accelerated thinking and speak very quickly but, overall, their functioning is not substantially impaired. The symptoms are not so severe as to hinder their ability to interpret reality or function in most areas of life.

10. What is dysthymia?

Dysthymia is a state of chronic depression severe enough that people are plagued by some symptoms of depression, but not so severe that the number of depressive symptoms meet criteria for a full-blown major depressive episode. It is a chronic, mild depression rather than a frank, severe depressive episode. There is evidence, however, that people who have dysthymia suffer from as much or more disability over the long run, as compared to those who have severe depressive episodes but recover in between. Like major depression, dysthymia is an illness that can be successfully treated with antidepressant medications.

11. What is major depression?

Major depression is a well-characterized medical illness that consists of a number of discrete symptoms. These include a persistently depressed mood for several weeks or longer and an inability to experience pleasure or enjoy normal activities.

Changes in basic functions include sleep and appetite disturbances, diminished interest in sex, and difficulty in making day-to-day decisions. Sufferers may also feel physically or cognitively anxious, agitated or very slow. Most conspicuously, they may sometimes have suicidal thoughts or even attempt suicide.

12. What is atypical depression?

Atypical depression distinguishes people who seem to have many of the symptoms of major depression, but have difficulty staying asleep or seem to sleep too much. Additionally, instead of having a diminished appetite, they have a marked increase in appetite, a sensitivity to interpersonal rejection and leaden paralysis-a feeling of being so depressed that it is major effort to do even basic tasks. Atypical depression resembles hibernation in that metabolism is slowed and sufferers sleep great lengths and eat excessively.

13. What is meant by a mixed state?

A mixed state is a combination of manic and depressive symptoms. While common, mixed states are underrecognized, with an estimated 40% of people who present with manic symptoms having a sufficient number of depressive symptoms to be diagnosed as being in a mixed manic and depressive state. Some studies have shown that suicidal thoughts are greatly increased in people in the midst of a mixed state. Treatment has been poorly studied, but recent evidence indicates that some of the newer medications, such as divalproex and olanzapine (Zyprexa), may be more beneficial than older drugs like lithium.