Lithium seems to be the gold
standard when it comes to bipolar
treatment. It is generally the first treatment of choice and has been
approved by the FDA for mania treatment since 1970. At this point, it
is a very effective mood stabilizer for bipolar treatment. Lithium is
effective in preventing the cycling effect that occurs between manic
and depressive episodes and this bipolar treatment is generally
maintained with the patient for long periods of time. The unfortunate
effect of lithium treatment however is that it acts as a mood
suppressant. Thus many patients begin to miss the excess energy that is
associated with their manic and hypomanic attacks. This results in
compliance issues with taking the medication.
Anticonvulsant medications are also a common drug of choice for
bipolar
treatment, and these include valproate and carbamazepine. Often these
are used as a lithium alternative as opposed to being used in
conjunction with lithium. FDA approval has been obtained for valproate
since 1995. Other anticonvulsants for bipolar treatment include
lamotrigine, gabapentin, and topiramate and these are all utilized as
mood stabilizers. Current research is suggesting that combinations of
lithium and any of these anticonvulsants may be a useful bipolar
treatment.
Depressive episodes in bipolar disorder are often offered
antidepressant medication for bipolar treatment that comes in
conjunction with the lithium treatment. It is not unusual for lithium
and anticonvulsants for mood stabilization to be prescribed with an
antidepressant. Again, the purpose of this would be to prevent the
cycling between mania and depression. Currently the antidepressants of
choice for bipolar treatment are tricyclic antidepressants such as
Tofranil. Unfortunately, antidepressants generally require at least a
few weeks to take effect. Patients also have a tendency to discontinue
use of the drugs when they start to feel better. This results in a
relapse because the underlying depressive episodes are still present
and are only suppressed by the medication. Because of this and because
depressive episodes tend to be a recurrent disorder the trend for
bipolar treatment now is to continue patients on the medication course
for a very long time in order to prevent recurrence.
Overall, when properly prescribed and monitored, medication use
in
bipolar treatment is very effective in terms of not only assistance to
cope with the life long disorder, but this bipolar treatment program is
effective in prevention as far as recurrent episodes are concerned.