What meds are for bipolar

Mood Stabilizers as a Treatment for Bipolar Mania

Written by WebMD Editorial Contributors

Which Bipolar Medicine Is Best?

Doctors use many types of drugs to treat bipolar disorder. Some fight the extreme highs of mania and others treat the lows of depression. You might take one drug at a time or a few at the same time.

The best bipolar medicine is the one that works best for you. Work with your doctor to decide on the medication plan that helps you the most.

You may keep taking these medications for years or decades, even if it’s been a long time since your last manic or depressive episode. This is called maintenance therapy and helps prevent recurrence of symptoms.

What Is Mood-Stabilizing Medication?

Mood stabilizers are medicines that treat and prevent highs (mania) and lows (depression). They also help to keep your moods from interfering with work, school, or your social life.

Examples include:

Carbamazepine (Carbatrol, Epitol, Equetro, Tegretol)
Divalproex sodium (Depakote)
Lamotrigine (Lamictal)
Lithium
Valproic acid (Depakene)

Some of these drugs are known as anticonvulsants, which are also used to treat seizure disorders, including carbamazepine, lamotrigine, and valproic acid.

Not all of these drugs have the same effects, though. Some (such as lithium) are better at treating mania. Others (such as lamotrigine) may be more useful for depression.

Keep in mind that the term "mood stabilizer" can be misleading. If you take one, your mood can still change during the day. These medicines treat full episodes of mania or depression that last for several days or weeks at a time.

Other Mood-Stabilizing Medicines

Drugs called antipsychotic medications are also common in bipolar treatment plans. You can take them alone or with mood stabilizers to help with symptoms of mania. These drugs include:

Haloperidol (Haldol)
Loxapine (Loxitane) or loxapine inhaled (Adasuve)

Today, doctors may prescribe newer antipsychotic drugs, including:

Aripiprazole (Abilify)
Asenapine (Saphris)
Cariprazine (Vraylar)
Lumateperone (Caplyta)
Lurasidone (Latuda)
Olanzapine (Zyprexa)
Olanzapine/samidorphan (Lybalvi)
Quetiapine fumarate (Seroquel)
Risperidone (Risperdal)
Ziprasidone (Geodon)

Medicines for Bipolar Depression

Most of the time, doctors will start bipolar disorder treatment by prescribing a mood-stabilizing drug like lithium. But the FDA has approved some medicines for bipolar depression, too:

Fluoxetine combined with olanzapine (Symbyax)
lumateperone (Caplyta)
Lurasidone (Latuda). You might take it alone or with lithium or valproic acid.
Quetiapine fumarate (Seroquel)

For some people, traditional antidepressants may trigger a manic episode. Because of this risk, your doctor should keep track of you closely if you take one.

Will the Medicine Work for Me?

Your doctor can’t predict how well a particular bipolar medication will work for you. You may need to try several different kinds and different doses to figure out the right approach. And that can take time.

It can be frustrating, but don't give up. Eventually, you and your doctor should be able to find a prescription that works for you.

Medication Tips

If you have bipolar disorder, taking your medication should be part of your routine. Take it at the same time every day. It's easier to remember if you do it along with another daily activity, like brushing your teeth, eating breakfast, or getting into bed. A weekly pillbox can help you see if you've missed a dose.

Be sure to talk to your pharmacist or doctor about the best time of day to take your bipolar medications. Some are best if you take them in the morning or at bedtime and others with meals or after meals.

Make sure you know what to do if you accidentally miss a dose. Ask your doctor. Don't assume that doubling up is a good idea.

Side Effects of Bipolar Drugs

Like any drug, bipolar medicines can cause some side effects. They vary depending on which medications you use. These side effects can include:

Nausea
Tremors
Hair loss
Sexual problems
Weight gain
Liver damage
Kidney damage
Diarrhea
Belly pain
Skin reaction

Some medications can affect how well your liver works or the amount of white blood cells or platelets you have. You may need regular tests to make sure that you're staying healthy. The antipsychotic drug ziprasidone (Geodon) is linked to a rare but serious skin reaction called DRESS syndrome (drug reaction with eosinophilia and systemic symptoms).

Many side effects will go away after a few weeks of treatment. If you still feel bad after that, see your doctor. Don't assume you have to just live with the side effects. Your doctor may be able to change your dose, give you another medicine to control the side effects, or try a different medication altogether.

Stick to Your Treatment

Medications for bipolar disorder are powerful drugs, and you must take them exactly as your doctor recommends. Don't stop taking a medicine without your doctor's approval. It can be dangerous.

When you're feeling good, you might decide that you want to stop taking your medication. But that's a bad idea unless your doctor agrees. Treatment only during mood episodes may not be enough to prevent symptoms from coming back. In most people, maintenance treatment between mood episodes makes mania and depression happen less often and makes them less severe. If you're feeling good now, that's likely because your medication is working. So stick with it.

Bipolar Disorder Guide

Overview
Symptoms & Types
Treatment & Prevention
Living & Support

Lamotrigine Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Warnings:

Rarely, serious (sometimes fatal) skin rashes have occurred while taking this medication. These rashes are more common in children than in adults. Rashes may be more likely if you start at too high a dose, if you increase your dose too quickly, or if you take this medication with certain other anti-seizure medications (valproic acid, divalproex). These rashes may occur anytime during use, but most serious rashes have occurred within 2 to 8 weeks of starting lamotrigine.

Get medical help right away if you develop any type of skin rash, or if you have other signs of a serious allergic reaction such as hives, fever, swollen lymph nodes, severe dizziness, painful sores in the mouth or around the eyes, swelling of the face/tongue/throat, trouble breathing, or liver problems (symptoms include stomach/abdominal pain, nausea/vomiting that continues, dark urine, yellowing eyes/skin). Your doctor will tell you if you should stop taking lamotrigine. Even after you stop taking this, it is still possible for a rash to become life-threatening or cause permanent scars or other problems.

Warnings:

Uses

Lamotrigine is used alone or with other medications to prevent or control seizures (epilepsy). It may also be used to help prevent the extreme mood swings of bipolar disorder in adults.This drug is not approved for use in children younger than 2 years due to an increased risk of side effects (such as infections).

How to use lamotrigine oral

Read the Medication Guide provided by your pharmacist before you start taking lamotrigine and each time you get a refill. If you have any questions regarding the information, consult your doctor or pharmacist.

Take this medication with or without food, usually 1 to 2 times daily or as directed by your doctor. Place the tablet on your tongue and move it around the mouth. Allow it to dissolve, and swallow with or without water, or use as directed by your doctor. If this medication comes in a blister pack, do not use the medication if the blisters are torn, broken, or missing.

Dosage is based on your medical condition, response to treatment, and use of certain interacting drugs. (See also Drug Interactions section.) For children, the dosage is also based on weight.

It is very important to follow your doctor's dosing instructions exactly. The dose must be increased slowly. It may take several weeks or months to reach the best dose for you and to get the full benefit from this medication. Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same time(s) each day.

Do not stop taking this medication without consulting your doctor. Some conditions may become worse when the drug is suddenly stopped. Your dose may need to be gradually decreased. Also, if you have stopped taking this medication, do not restart lamotrigine without consulting your doctor.

Tell your doctor if your condition does not improve or if it worsens.

Side Effects

Precautions

Before taking lamotrigine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, liver disease, heart problems (such as irregular heartbeat, heart block, heart failure).

This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Children may be at greater risk for skin rashes while taking this drug. See also Warning section.

Older adults may be more sensitive to the side effects of this drug, especially dizziness, loss of coordination, or fainting. These side effects can increase the risk of falling.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

This drug passes into breast milk and may have undesirable effects on a nursing infant. Discuss the risks and benefits with your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug include: dofetilide, orlistat.

Other medications can affect the removal of lamotrigine from your body, which may affect how lamotrigine works. Examples include hormonal birth control (such as pills, patches), estrogens, other medications to treat seizures (such as phenobarbital, phenytoin, primidone, valproic acid), certain HIV protease inhibitors (such as lopinavir/ritonavir, atazanavir/ritonavir), and rifampin, among others. Your doctor may need to adjust your dose of lamotrigine if you are on these medications. If you are using hormonal birth control or estrogens, tell your doctor right away of any changes in your menstrual pattern (such as breakthrough bleeding).

This medication may decrease the effectiveness of hormonal birth control such as pills, patch, or ring. This could cause pregnancy. Discuss with your doctor or pharmacist if you should use additional reliable birth control methods while using this medication. Also tell your doctor if you have any new spotting or breakthrough bleeding, because these may be signs that your birth control is not working well.

Tell your doctor or pharmacist if you are taking other products that cause drowsiness, including alcohol, marijuana (cannabis), antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and opioid pain relievers (such as codeine).

Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

This medication may interfere with certain laboratory tests (including urine drug screening tests), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

Does lamotrigine oral interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe drowsiness, unusual eye movements (nystagmus), loss of consciousness.

Do not share this medication with others.

Laboratory and/or medical tests (such as liver/kidney function, complete blood count) may be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

There are different types of this medication available. Some do not have the same effects. There are also some medications that sound the same as this product. Make sure you have the right product before taking it.

It is important to take each dose at the scheduled time. If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Store at room temperature away from heat, light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.