Bipolar Disorder Treatments

Medications

Many patients are treated with a combination of two or more of these medications:

• Lithium —a mood stabilizer, often used as initial treatment (helps prevent manic and depressive episodes from returning)
• Antiseizure medications—also used as mood stabilizers instead or in combination with lithium
  • Depakote (Valproate)
  • Carbamazepine (Tegretol)
  • Lamotrigine (Lamictal)
  • Topiramate (Topamax)
• Benzodiazepines—can be used to treat agitation or insomnia
  • Clonazepam (Klonopin)
  • Lorazepam (Ativan)
• Zolpidem (Ambien)—used to treat insomnia
• Antidepressants (serotonin reuptake inhibitors or bupropion [Wellbutrin])—used to treat depression
• Antipsychotic medications—used for acute manic or mixed episodes and maintenance treatment
  • Classic antipsychotic medications (eg, haloperidol [Haldol]) are not often used because of risks of tardive dyskinesia (uncontrollable movements)
  • Atypical antipsychotic medications (eg, risperidone , olanzapine , aripiprazole , ziprasidone , and quetiapine ) are more effective with less risk of tardive dyskinesia

The plan is based on the pattern of the illness. Treatment may need to be continued indefinitely. It should prevent significant mood swings.

Psychotherapy

Psychotherapy may include:

• Cognitive-behavioral therapy
• Counseling
• Family therapy
• Interpersonal and social rhythm therapy, a form of therapy designed to treat bipolar disorder

Electroconvulsive Therapy

Electroconvulsive therapy may be effective when medications fail. It can be used for both mania and depression.