Jan 11th 2023
Bipolar disorder is a mental illness in which the usual ups and downs of emotional states are extremely exaggerated. People with bipolar disorder can have manic episodes (with an elevated mood and increased activity) or depressive episodes (feeling sad and lower activity). Depending on the symptoms, it can often be treated with medication.
Medication can be used to control the symptoms of bipolar disorder. These include:
Mood stabilizers are the main form of medical treatment for bipolar disorder, with the most widely available being lithium 
They work by preventing mood swings or reducing their severity. Lithium has also been shown to have a role in prevention of suicide attempts among bipolar patients. 
Mood stabilizers are known to cause adverse effects. Lithium cause tremors, weight gain or lead to hypothyroidism. Valproate can cause weight gain, nausea and vomiting, as well as alopecia, tremors and easy bruising. Carbamazepine can cause nausea, vomiting, diarrhea, and hyponatremia (low blood sodium). Lamotrigine’s side effects include rashes, nausea, dizziness, and tremors. 
Atypical antipsychotic medications have been widely studied for their efficacy in treating acute mania. To date, the data suggests that the most effective of these are olanzapine, risperidone, quetiapine, aripiprazole, and ziprasidone. These antipsychotic drugs can be used as an alternative to or in conjunction with certain mood stabilizers such as lithium or divalproex. 
Antipsychotics help to prevent or suppress manic symptoms (euphoric/irritable mood and increased activity or energy).
Antipsychotics have a range of side effects. They can be relatively minor (e.g., mild sedation or dry mouth) to very unpleasant (e.g., constipation, sexual disfunction).
More severe side effects can be painful (e.g., involuntary muscle spasms), disfiguring (e.g., weight gain), or life threatening (e.g., heart attack).  Therefore, it is extremely important that you tell your doctor or health care provider immediately if you feel that something is wrong.
Bipolar depression is often treated with antidepressant medication in conjunction with a mood stabilizer. An antidepressant taken alone can trigger an episode of mania or rapid cycling in someone who has bipolar disorder. Antidepressants work by increasing the function of nerve cells in the brain that release the neurotransmitter serotonin. This is the chemical in the body that regulates mood.
Common side effects can include:
It should be noted that these are off label medications for bipolar disorder, and the efficacy of antidepressants in bipolar depression remains unproven. 
There is increasing evidence for the role of anticonvulsants in the effective treatment of bipolar disorder, including valproate, lamotrigine, carbamazepine/oxcarbazepine, and topiramate. However, only valproate is currently approved by the FDA for treatment of acute mania. Other anticonvulsants include carbamazepine, lamotrigine, and gabapentin, all with varying degrees of efficacy in treating bipolar disorder. 
Anticonvulsants are primarily used as antiepileptic, or antiseizure, drugs in the treatment of epileptic seizures. They have become increasingly common in the treatment of bipolar disorder because of their mood-stabilizing qualities.
Side effects of anticonvulsants can include, dizziness, drowsiness, fatigue, nausea, tremors, reach and weight gain.
The mainstay of anti-anxiety medications are benzodiazepines. These are prescribed for other medical conditions as well as anxiety, such as insomnia and alcohol withdrawal.
The most concerning side effect of benzodiazepines is dependence. Benzodiazepines can be extremely addictive, and doctors should be careful in prescribing them to people with a history of addiction. Other side effects include drowsiness, light-headedness, confusion, dizziness, and unsteadiness.
Medication isn’t the only method used to treat bipolar disorder. Alternatives include a range of therapies, which can be used as a standalone treatment, but are more commonly used in conjunction with medication.
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