How is Bipolar Disorder Treated?

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Persons diagnosed with bipolar disorder are diagnosed with an incurable illness, but several treatment options are in place to address and relieve the symptoms of the disorder. They include medications, psychotherapy, and even electroconvulsive therapy.

Medication

Typically, front-line therapy for bipolar disorder involves prescription medications. These come from one of three classes of drugs: mood stabilizers, atypical antipsychotics, and in some cases antidepressants.

Mood Stabilizers

Mood stabilizers are the front-line therapy in terms of pharmacologic response to bipolar disorder. Patients are often put on mood stabilizers for many years. They include the oldest such drug, Lithium, as well as the most commonly prescribed alternative to Lithium, Valproic acid or divalproex sodium (Depakote). It is widely considered to be as effective as Lithium in symptom control. Furthermore, the FDA's latest approval for maintenance treatment of the disorder is Lamictal (lamotrigine).

Atypical Antipsychotics

Atypical antipsychotic medications sound crazier than they are. They are only dubbed 'atypical' because they are considered to be second-generation anti-psychotic drugs. It's just to differentiate the two groups. Atypical antipsychotics are often prescribed in concert with another medication. They include Zyprexa (olanzapine), used for maintenance therapy, with antidepressants, or even administered in injection for fast relief of symptoms. On the negative side, this drug is associated with some unpleasant side effects.

Ability (aripiprazole) is a lot like Zyprexa in its uses and efficacy. Seroquel (quetiapine) is effective at relieving symptoms of manic episodes. And two other drugs are also available: Risperdal (risperidone) and Geodon (ziprasidone).

Antidepressants

Antidepressants in the treatment of bipolar disorder are tricky because they can cause a person to make rapid jumps from high to low so doctors almost always prescribe them in concert with a mood stabilizer, although according to the NIMH fact-sheet, there's little evidence supporting the addition of antidepressants such as Prozac, Paxil, Zoloft or Wellbutrin to a mood stabilizer.

Psychotherapy

Medications aren't the answer for every patient. Some bipolar patients benefit from talk therapy or cognitive-behavioral therapy, or some other form of psycho-social therapeutic intervention. This can occur along with taking medications if the health professional sees fit.

Electroconvulsive Therapy

It's not quite as dramatic as it sounds.

Yes, Electroconvulsive Therapy (ECT) once went by the name "shock therapy," and it conjures up awful images of psych ward cruelty. But ECT has its place in the treatment of bipolar disorder, if only as a last resort or at the least, not as a front-line therapy.

Patients receiving ECT are put under anesthesia and don't feel the electrical impulses, which can last as long as 90 seconds. It is an outpatient treatment, and recovery is measured in minutes. It is considered a safe and effective treatment modality for the severely afflicted.

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