Bipolar Disorder

Overview

Formerly known as manic depressive disorder due to its extreme mood swings from depression, bipolar disorder is a very serious condition and can result in suicidal tendencies. Treatment usually comprises of therapy and medication.

Earlier, patients were given sedatives which had multiple side effects. Now, the main treatment for bipolar disorder is mood stabilizing drugs. Doctors prescribe lithium, an antipsychotic drug or a combination of both.

Although depression is more common than manias and can drastically impact the lives of patients, there are a very few treatment options for bipolar disorders

What's the standard treatment for bipolar depression?

Psychiatrists for years have added antidepressants to mood stabilizers incase the mood stabilizer is ineffective, but research shows that antidepressants are often times not effective for bipolar disorders.

According to the American Psychiatric Association (APA), lithium, lamotrigine, valproate, carbamazepine, and most atypical antipsychotic medications are approved by the FDA for treating one (or more) phases of bipolar disorder.

In some patients with bipolar disorder, a mood stabilizer may be all that’s needed to modulate the depressed mood. However, in bipolar patients who do not respond to one mood stabilizer, another mood stabilizer or an atypical antipsychotic is sometimes added to the treatment regimen.

Are antidepressants used to treat bipolar depression?

A very large randomized study sponsored by the National Institute of Mental Health (NIMH) called the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) showed that mood stabilizers alone produced a stable improvement only in about 1 in 4 people with bipolar depression, and surprisingly, adding an antidepressant to the mood stabilizer did not boost improvement further. The STEP-BD study underscored the need to find treatments other than mood stabilizers or antidepressants for bipolar depression.

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