Treatment of Bipolar Psychosis with Medications

Treatment of bipolar psychosis entails the use of bipolar medications including antipsychotic medication.

Bipolar psychosis treatment is complicated due to the presence of mania and depression. Luckily, the medications used to treat mania and depression can often end and prevent the psychosis as well. But not always! Which is why many people with bipolar disorder take antipsychotics along with other bipolar medications. (The term neuroleptics is sometimes used in place of antipsychotics.) Before I go into the antipsychotic medication category, here is a recap of the medications used to treat bipolar disorder and whether they affect psychosis. 

Lithium: A naturally occurring salt primarily used to treat bipolar mania - though it can help with depression symptoms as well. This is the only true 'mood stabilizer.' Considering that psychosis is always attached to either mania or depression, it makes sense that using Lithium to manage the mania can also prevent psychosis. The problem is that the side-effects can be very intense at the high doses needed to manage psychotic mania.

Anticonvulsants: Depakote (Divalproex), Tegretol (carbamazepine) and Lamictal (lamotrigine). These drugs are used to regulate moods, but as they were originally created to treat epilepsy, they are not classified as mood stabilizers. Like Lithium, the anticonvulsants Depakote and Tegretol are mainly anti-mania drugs. When they successfully manage mania, possible psychosis can be managed as well. Lamictal is used to treat bipolar depression. I have found that Lamictal also greatly helps with my psychosis and rapid cycling although it is not usually prescribed for psychosis.

Though the above drugs are not classified as antipsychotics, they actually do help treat psychotic symptoms by managing the mania and depression. Because of this, they are the first line of treatment for managing bipolar disorder. The less medications the person can take, the better. When these drugs work successfully, antipsychotics are not as needed.

Unfortunately, these medications do not always work as well as one would hope and the bipolar psychosis needs separate treatment with antipsychotics. These medications are often very effective, but as with many drugs, they can come with some very strong side-effects. It's always important to remember that the medication treatment of bipolar disorder is chemotherapy. This means that the drugs can help immensely, but there is always a trade-off in terms of bipolar medication side effects.