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Medications known as "mood stabilizers" usually
are prescribed to help control bipolar disorder.
Several different types of mood stabilizers
are available. In general, people with bipolar disorder continue treatment with
mood stabilizers for extended periods of time (years). Other medications are
added when necessary, typically for shorter periods, to treat episodes of mania
or depression that break through despite the mood stabilizer.
 | Lithium, the first mood-stabilizing medication
approved by the U.S. Food and Drug Administration (FDA) for treatment of
mania, is often very effective in controlling mania and preventing the
recurrence of both manic and depressive episodes.
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| Anticonvulsant medications, such as valproate
(Depakote®) or carbamazepine (Tegretol®), also can have mood-stabilizing
effects and may be especially useful for difficult-to-treat bipolar episodes.
Valproate was FDA-approved in 1995 for treatment of mania.
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| Newer anticonvulsant medications, including
lamotrigine (Lamictal®), gabapentin (Neurontin®), and topiramate (Topamax®),
are being studied to determine how well they work in stabilizing mood cycles.
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| Anticonvulsant medications may be combined
with lithium, or with each other, for maximum effect.
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| Children and adolescents with bipolar disorder
generally are treated with lithium, but valproate and carbamazepine also are
used. Researchers are evaluating the safety and efficacy of these and other
psychotropic medications in children and adolescents. There is some
evidence that valproate may lead to adverse hormone changes in teenage girls
and polycystic ovary syndrome in women who began taking the medication before
age 20.14 Therefore, young female
patients taking valproate should be monitored carefully by a physician.
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| Women with bipolar disorder who wish to
conceive, or who become pregnant, face special challenges due to the possible
harmful effects of existing mood stabilizing medications on the developing
fetus and the nursing infant.15 Therefore,
the benefits and risks of all available treatment options should be discussed
with a clinician skilled in this area. New treatments with reduced risks
during pregnancy and lactation are under study. |
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