Medications may include: Mood stabilizers. You'll typically need mood-stabilizing medication to control manic or hypomanic episodes. Examples of mood stabilizers include lithium (Lithobid), valproic acid (Depakene), divalproex sodium (Depakote), carbamazepine (Tegretol, Equetro, others) and lamotrigine (Lamictal).
Lithium: The first mood stabilizer for bipolar disorder. Mood stabilizers are medications that help control the highs and lows of bipolar disorder. They are the cornerstone of treatment, both for mania and depression. Lithium is the oldest and most well-known mood stabilizer and is highly effective for treating mania.
Symptoms of depressive episodes include low energy and motivation, lack of interest in daily activities and sometimes suicidal thoughts. Bipolar disorder is a chronic disease, and while there is no cure, there are medicines and other therapies that can help people function well and lead fulfilling lives.
Sublingual dexmedetomidine (Igalmi) was approved last year for acute agitation in adult patients with schizophrenia or bipolar I or II disorder. Keep a look out for these medications, as xanomeline-trospium will be coming in 2023 and lumateperone, Rykindo, and Igalmi have been FDA-approved within the past year.
Lumateperone (Caplyta) and Quetiapine (Seroquel, Seroquel XR) is used for the short-term treatment of bipolar depression. Another option is olanzapine (Zyprexa) with fluoxetine (Prozac). The atypical antipsychotic lurasidone (Latuda) can be taken alone or with lithium or valproate for treating bipolar depression.
The life expectancy for someone with bipolar disorder is approximately 67 years old. A 2021 study researched the effect of bipolar disorder on longevity and found that: risk of death is 2.6 times greater than the general population. the average life span is between 8–12 years shorter than the general population.
“Untreated bipolar disorder can worsen with age, with both the frequency of mood episodes and their duration,” says Thomas Scary, MD, MA, staff psychiatrist, Rittenhouse Psychiatric Associates in Philadelphia. “This is true even with treatment, but to a lesser extent.”
It has long been known that lithium has toxic effects on the thyroid gland and the kidneys. The thyroid toxicity, caused primarily by lithium's interference with thyroid hormones' release from the gland (19) affects up to 19% of treated patients (20).
Lamotrigine. Lamotrigine (Lamictal) may be the most effective mood stabilizer for depression in bipolar disorder, but is not as helpful for mania. The starting dose of lamotrigine should be very low and increased very slowly over four weeks or more.
Lithium is a long-term treatment for episodes of mania and depression. It's usually prescribed for at least 6 months. If you're prescribed lithium, stick to the prescribed dose and do not stop taking it suddenly unless told to by your doctor. For lithium to be effective, the dosage must be correct.
The ones that treat bipolar depression are cariprazine (Vraylar), lurasidone (Latuda), olanzapine-fluoxetine combo (Symbyax), and quetiapine (Seroquel). Among them, lurasidone offers a good balance of efficacy and tolerability.
Commonly recommended medications for comorbid bipolar and anxiety disorders include: First line: gabapentin, quetiapine. Second line: divalproex sodium, lamotrigine, serotonergic antidepressants,* olanzapine, olanzapine-fluoxetine* combination.
Treating Borderline Personality Disorder
Not only is BPD one of the most painful mental illnesses, but it's also intensified by stigma and being misunderstood by others.
Bipolar disorder often runs in families, and research suggests this is mostly explained by heredity—people with certain genes are more likely to develop bipolar disorder than others. Many genes are involved, and no one gene can cause the disorder.
Bipolar disorder is associated with a two- to threefold increased risk of premature mortality, including not only suicide death, but also cardiovascular disease, respiratory disease, and cancer.
No two people with bipolar disorder share the same thoughts or experiences, but there are some common thought patterns among most folks who have it. This includes cyclical thinking, manic and/or depressive episodes, suicidal ideation, and psychosis.
Bipolar disorder is frequently inherited, with genetic factors accounting for approximately 80% of the cause of the condition. Bipolar disorder is the most likely psychiatric disorder to be passed down from family. If one parent has bipolar disorder, there's a 10% chance that their child will develop the illness.
Caplyta is now FDA-approved for depressive episodes from bipolar I and II. The US Food and Drug Administration (FDA) has approved Caplyta (lumateperone) for the treatment of bipolar depression in adults.
Currently, there are only 3 drug treatments approved for the acute bipolar depression: olanzapine/fluoxetine combination (OFC), quetiapine (immediate or extended release), and lurasidone (monotherapy or adjunctive to lithium or valproate).