Treatment for Bipolar Disorder

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Remedy from Bipolar Disorder (BD), lifetime and recurrent disease, is almost impossible. Nevertheless, it’s possible to control the illness by taking proper medication & therapy. The primary objective is to use those medications to control mood swing and depression. The side effects of any medications are unavoidable. Despite all the side effects, patients have been trailed with different drugs because every individual is not responding same way to those medications. Multiple medications have been used to find out best course to treat patients. In order to successfully control this disorder patients have to educate about this illness, follow certain life style and take some psychotherapy. Only medications single handed are not beneficial to treat BD.

Mood Stabilizing Medication

The first choice of treating by BD is mood stabilizing medication. Many of the anticonvulsant drugs (gabapentin, topiramate, oxcarbazepine) are also categorized as mood stabilizing medications. Although anticonvulsant drug generally used to treat seizure, they can also regulate mood swing. Medications are particularly deigned to control the symptoms. It’s essential to continue medication for long period to stay away from relapse.

Lithium (Lithobid or Eskalith), mood stabilizing medication, is the first medication to introduce for treating BD in 1970s. Lithium mainly focused to stabilize the rapid cycling and mania. Lithium is still now one of the most popular medications for to treat BD. However Lithium disrupts the normal thyroid hormones level in our body. It decreases thyroid hormone level which causes hypothyroidism. Moreover, hypothyroidism rate is found twice much higher in female than male. Female patients with BD who are taking lithium developed hypothyroidism with increasing age and showed higher rate of thyroid autoimmunity. Thyroid hormone is important to maintain the normal brain functions. Particularly, decreasing level of thyroid hormone enhance the possibility of feeling frequent depressive episodes and mood swing in BD patients. Patient who is taking lithium related medications, especially female, should consulate with experts to maintain their regular thyroid level [Bibliography item 1 not found.] . BD patients those are treated with lithium usually exhibit excess weight gain. The proper mechanism is not clear. It’s been suggested that due to use of lithium our plasma adiponectin level is gone down. It has been found in many experiments that animal with low level of adiponectin expression display obesity related metabolic and cardio-vascular disease. It might be cause of weight gain in BD patients but long study needed to confirm [Bibliography item 2 not found.].

Valproic acid, also familiar as Divalproex Sodium (Depakote) and mood stabilizing medication, is mainly prescribed to treat with mania¬. It‘s generally do the same things like lithium. Valproic acid has caused polycystic ovary syndrome (PCOS) and hyperandrogenism in woman. Most of the woman with PCOS also exhibit obesity and polycystic ovarian morphology (PCOM). Furthermore, female patient with BD who take valproic and also developing PCOS are more susceptible to emerge different illness like diabetics, reduce fertility, cardio-vascular disease. Many studied suggested female start improving from PCOS after discontinuing taking valproic. On the other hand, the obesity and PCOM condition don’t show any improvements[Bibliography item 3 not found.] . The combination of Valproic and other medications illustrate more effectiveness than mono-therapy of valproic. Valproate with lithium is more efficient to inhibit the relapse than monotherapy of valproate.

Atypical Anti-psychotic Medication

Many anti-psychotic and anti-depressant (Prozac, Zoloft) have been used for treating mixed episodes and depressive episode. It’s called atypical to separate from conventional or first generation drugs. There are quiet few drugs like Olanzapine (Zyprexa), Aripiprazole(Abilify),Quetiapine(Seroquel),Risperidone(Risperdal) are in the getting popularity for treatment .Studied disclosed that atypical antipsychotic drugs are more effective than mood stabilizing medication for treating pediatric bipolar disorder in children. Those who started with mood stabilizing medication are more likely discontinue their treatment compare to those who started atypical antipsychotics medication [Bibliography item 4 not found.]. However, weight gain is one of the common side effects of atypical drugs .It also make patients susceptible to diabetics and high cholesterol. Long-time taking atypical drugs might cause tardive dyskinesia. Sometimes antidepressant drugs are prescribed for treatment .It’s been advised to combine mood stabilizing medication (lithium or valproic acid) and anti-depressant drugs together because it’s minimizing the negative effect of anti-depressant drugs.


Psychotherapies are really helpful to treat BD because it has very negligible side effects. Moreover, It have deigned to educate and aware about their illness. Some of the psychotherapies involve family members, relative and friends to support patients. Different kinds of psychotherapy have been introduced to treat BD.

Cognitive Behavioural therapy (CBT) helps patients to learn change negative thought pattern and behaviours and family-focused therapy improves communication among family members. Particularly, family members have been notified that how they can help patients. In addition, Interpersonal and social rhythm therapy is getting popularity. This session provides a chance to patients get together and share their own thought as well as they try to help each other to improve their day to day work. Psych-education provides information to patient about their illness. BD patients normally have faced disturbance of their sleep cycle which can trigger depression and mania. There is light and dark therapy that helps to regulate our normal biological clock and prevent rapid cycling.
On the other hand, electroconvulsive therapy (ECT), shock therapy, is used when medication and psychotherapies don’t work effectively. It had a bad reputation before but in recent years it has been improved dramatically. Patients have been given some muscles relaxant and its put them in brief anaesthesia state. The shock stays for last 30-90 seconds and patients can recover in within 10-15 minutes. Patients might feel disoriented and experience some memory loss. Normally, patients recover from the side effect quickly. This treatment is recommended to pregnant women because ECT has no effect on the future child.

Medications have described above have some sorts of side effects. All medications have some common side effects. Drowsiness, Headache, Agitation, sleep disorder are the common problems patients faced when they start taking medications. Those reactions give researcher chance to find the proper target for developing proper drugs.

:: 1 :: 1. Ozerdem A, Tunca Z, Cımrın D, Hıdıroglu C, Ergor G. Female vulnerability for thyroid function abnormality in bipolar disorder: role of lithium treatment. BIPOLAR DISORDER S AN INTERNATIONAL JOURNAL OF PSYCHITRY AND NEUROSCIENCE 16, 72–82(2014)
2. Márcio Gerhardt Soeiro-de-Souzaa , Philip W. Gold , Andre R. Brunoni , Rafael T. de Sousa , Marcus V. Zanetti , André F. Carvalho, Wagner Farid Gattaz ,Rodrigo Machado-Vieira , Antônio Lúcio Teixeira. Lithium Decreases Plasma Adiponectin Levels in Bipolar Depression. Neuroscience Letters 564 ,111–114(2014)
3. Hadine Joffe, Lee S. Cohen, Trisha Suppes, Cindy H. Hwang, Francine Molay, Judith M. Adams, Gary S. Sachs, and Janet E. Hall. Longitudinal Follow-up of Reproductive and Metabolic Features of Valproate-Associated Polycystic Ovarian Syndrome Features: A Preliminary Report. BIOL PSYCHIATRY 60,1378 –1381(2006)
4. Hua Chen, Sonam Mehta , Rajender Aparasu , Ayush Patel and Melissa Ochoa-Perez . Comparative effectiveness of monotherapy with mood stabilizers versus second generation (atypical) antipsychotics for the treatment of bipolar disorder in children and adolescents. Pharmacoepidemiology and Drug Safety 23, 299–308(2014)

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