Table of ContentsView AllTable of ContentsPrescription MedicationsPsychological TherapiesComplementary TreatmentsLifestyle ChangesFinding TreatmentNext in Bipolar Disorder GuideLiving With Bipolar Disorder
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Table of Contents
Prescription Medications
Psychological Therapies
Complementary Treatments
Lifestyle Changes
Finding Treatment
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Bipolar disorder is typically a lifelong illness with episodes that are highly variable and unique to each individual. Treatment is complex and often involves more than one medication over time. Talktherapy, complementary medicine, andlifestyle modificationscan also help, but psychiatric medications are the mainstay of treatment.
Verywell / Emily Roberts
Medications can help a person with bipolar illnessmanage their symptoms and function well in everyday life. A person who hasbipolar disordertends to experienceextreme highs(mania) andextreme lows(depression). Certain medications helpstabilize your moodso you don’t experience severe highs and lows.
Since drug therapy is an important component of treatment for bipolar disorder, it’s important to educate yourself about the various medication options. A psychiatrist will choose which medications are likely to work best for your symptoms. At times, your medications may need to be adjusted or changed.
If you have bipolar disorder and you’re unhappy with the medication that you’re currently on—perhaps you feel like it’s not working well enough or maybe you’re experiencing a side effect that you simply can’t stand—remember that it’s never a good idea to stop taking a medication cold turkey or change the dose of a medication without first talking to your doctor.
If you need to switch medications, your physician or psychiatrist will advise you on how to do so safely.
Anti-Convulsants
Anticonvulsants, also known as anti-seizure medications, are sometimes used asmood stabilizersin bipolar disorder:
Antipsychotics
First-generation antipsychotics, also known astypical antipsychotics, include:
Atypical antipsychotics have fewerextrapyramidal side effectswhen compared to typical antipsychotics. But some, especially clozapine and olanzapine, carry a high risk of metabolic syndrome. Atypical antipsychotics include:
Black Box WarningAntipsychotics (atypical and typical) are not approved for the treatment of older adults with dementia-related psychosis. The FDA issued ablack box warningfor this population due to an increased risk of death mostly due to pneumonia and cardiovascular events.
Black Box Warning
Antipsychotics (atypical and typical) are not approved for the treatment of older adults with dementia-related psychosis. The FDA issued ablack box warningfor this population due to an increased risk of death mostly due to pneumonia and cardiovascular events.
Antidepressants
Selective serotonin reuptake inhibitors (SSRIs)are antidepressants that are commonly prescribed for major depressive disorder but can also be prescribed for bipolar depression. SSRIs include:
The serotonin-norepinephrine reuptake inhibitors (SNRIs) include:
Tricyclic antidepressantsare an older class of antidepressants that, while effective for some people, carry a large side effect profile including heart arrhythmias and anticholinergic side effects like dry mouth, sedation, and constipation:
There are also antidepressants that do not necessarily fit into the above categories, like mirtazapine (Remeron), trazodone (Oleptro, Desyrel), vilazodone (Viibryd), vortioxetine (Trintellix), andbupropion(Wellbutrin).
Benzodiazepines
Benzodiazepinesdepress a person’s central nervous system and are used to treat anxiety, insomnia, and seizures. Benzodiazepines have differenthalf-lives, meaning some are short-acting, intermediate-acting, or long-acting. They include:
Other Medications
There are a number of other medications used for the treatment of bipolar disorder. Some are used quite commonly but do not necessarily fit into one of the common categories of psychiatric medication.
One example islithium(Lithane, Lithobid, Lithonate, Eskalith, Cibalith-S, Duralith), which is an element and was the first treatment for bipolar disorder. Although it requires careful monitoring, it is still commonly and effectively used as a first-line mood stabilizer.
On the other hand, verapamil (Calan, Isoptin), is a blood pressure medication that has been tried experimentally in the treatment of mania.
Manysymptoms of bipolar disorderimpact emotional well-being, so psychotherapy can often be helpful. Therapy sessions should take place with trained mental health professionals who can help identify when your moods are changing, triggers that lead to depressive or manic episodes, and skills to cope with bipolar disorder. Therapy can also increase medication compliance, help you connect with others in the bipolar disorder community, and reduce any negative behaviors that affect your quality of life.
There are several types of psychotherapy (talk therapy) that might be considered such ascognitive behavioral therapy (CBT),dialectical behavioral therapy (DBT),interpersonal and social rhythm therapy (IPSRT), and family treatment. Involving loved ones in your treatment can help members of your family gain a better understanding of bipolar disorder and it can assist them in supporting your treatment.
The Best Online Therapy ProgramsWe’ve tried, tested and written unbiased reviews of the best online therapy programs including Talkspace, Betterhelp, and Regain.
It’s important to talk to your doctor before trying any alternative treatments. Herbal supplements, likeSt. John’s Wort, could interfere with your medication or it may even trigger a manic episode. Studies have shown it may alleviate mild to moderate depression.
Another complementary treatment for aspects of bipolar disorder isphototherapy, also known as lightbox therapy. It is often used to treat seasonal depression.
Evidence regarding the benefits of omega-3 fatty acids or acupuncture, on the other hand, is inconsistent. There is not currently much data available supporting the effectiveness of other alternative interventions in bipolar disorder (e.g., aromatherapy, massage therapy, yoga) although they may be beneficial in terms of general self-care.
Before starting any type of alternative treatment, talk to your physician or psychiatrist.
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Your doctor and therapist will likely talk to you about strategies tomanage your lifestyle, including:
Treatment for bipolar disorder can be initiated once you have recieved a proper diagnosis. Your physician will likely refer you to a psychiatrist or other mental health professional. Be sure to speak openly with your physician and mental health professional about your symptoms, behaviors, moods, and anything else you notice in your daily life.
Bipolar Disorder Discussion GuideGet our printable guide for your next doctor’s appointment to help you ask the right questions.Download PDFSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
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Remission is about gaining stability and keeping your bipolar disorder under control, and that’s what most people who have bipolar disorder are hoping for—a productive and harmonious life. Achieving stability usually requires medication as part of the treatment plan.
If you or a loved one are struggling with bipolar disorder, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.For more mental health resources, see ourNational Helpline Database.
If you or a loved one are struggling with bipolar disorder, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.
For more mental health resources, see ourNational Helpline Database.
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4 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Apaydin EA, Maher AR, Shanman R, et al.A systematic review of St. John’s wort for major depressive disorder.Syst Rev. 2016;5(1):148. doi:10.1186/s13643-016-0325-2
Sarris J, Mischoulon D, Schweitzer I.Omega-3 for bipolar disorder: Meta-analyses of use in mania and bipolar depression.J Clin Psychiatry. 2012;73(1):81-86. doi:10.4088/JCP.10r06710
Sarris J, Lake J, Hoenders R.Bipolar disorder and complementary medicine: Current evidence, safety issues, and clinical considerations.J Altern Complement Med. 2011;17(10):881-890. doi:10.1089/acm.2010.0481
American Psychiatric Association.Practice Guideline for the Treatment of Patients with Bipolar Disorder Second Edition. 2010.Hamer AM & Muench J.Adverse effects of antipsychotic medications.Am Fam Physician. 2010 Mar 1;81(5):617-22.Ravindran AV, da Silva TL.The role of complementary and alternative therapies for the management of bipolar disorder. Vol 1. Oxford University Press; 2017. doi:10.1093/med/9780198748625.003.0029
American Psychiatric Association.Practice Guideline for the Treatment of Patients with Bipolar Disorder Second Edition. 2010.
Hamer AM & Muench J.Adverse effects of antipsychotic medications.Am Fam Physician. 2010 Mar 1;81(5):617-22.
Ravindran AV, da Silva TL.The role of complementary and alternative therapies for the management of bipolar disorder. Vol 1. Oxford University Press; 2017. doi:10.1093/med/9780198748625.003.0029
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