Bipolar Medication - Facts - Side Effects - Alternatives

Lithium
Lithium-side effects and possible complications.:

Can cause an increase in mood cycling.
(treated w/thyroid replacement meds) (Mondimore, F. M., M.D. 2006. p.91)

"Lithium has been associated with birth defects."
Stopping after finding out one is pregnant "may be too late to prevent a birth defect." (Ibid, p.91).

"A noticeable dulling of mental functioning and coordination," is listed as a major side effect. (Ibid, p. 92). "Patients often complain that their ability to memorize and learn is affected and that they have a difficult-to explain sense of mental sluggishness."(Ibid, p. 92).

Several studies maintaining bipolar patients on lithium for five years or more found only just over one-third remained in remission. (Carson, R.C., Butcher, J.N. Mineka, S., 2000. p.638)

Valporate
Valporate-milder side-effects profile than lithium. (Ibid, p.94)

Sometimes can lead to liver problems. p. 95 "birth defects" (Ibid, p.95).

"[M]any newer medications don't seem to be more effective than available older ones when studied in large groups of patients." (Ibid, p.96).

One good, well-designed study concludes that (Tegretol) and similar medications have less success than lithium. It is therefore recommended as a secondary medication rather than a first line. Again side effects can be, "sleepiness, light-headedness, some initial nausea," as well as other physical side effects. (Ibid).

Risperdine
"My bipolar patients have not had very good success with risperdal. Several of my patients have become worse while taking it." (Fawcett, Golden, p. 94)

Depakote, Depakene.
Are used for both bipolar disorder and seizures.

Many meds used for BP are also used for epilepsy.

Clozopine "Very sedating"
"Can cause blood problems." (Fawcett, Golden)

Sedatives:
Studies have shown that sedatives can make people "more irritable and angry even without their realizing." Also "addictive, induce withdrawal. (Burgess, W. p.95)

Doesn't recommend sedatives. Such as Xanax (alprazolam) Iorazenar (Ativan) Clonazepam (Klonopin) and Diazepam (Valium) for BD.

Zyprexa as the best atypical "However it is sedating." P. 93

Olanzapine. Weight gain and diabetes have been issues with Zyprexa. (Burgess) [There have been lawsuits of late with use of Zyprexa in connection with diabetes].

Soloquel (SeroqUel) is "sedating".

Carbamazepine (Equetro, Tegretol, carbatrol, others). They are also used for epilepsy are "Mildly sedating." (Burgess, W., p.78)

Dr's Burgess, Fawcett, Golden and Mondimore have written thorough, authoritative references on bipolar disorder and all prescribed medication for treatment of mental illness and bipolar disorder in their practice. From their works, we can realize, that there are certain risks and serious side effects involved with taking medications for bipolar disorder, that most pharmaceutical treatments for BD are sedating, and that much can be accomplished trough lifestyle changes, and various therapies.

Paxil is an SSRI of special note for those with bipolar disorder, or who might be depressed and have a tendency towards mania. The following is a quote from Marcia Purse's newsletter on BD, from About.com, which accurately describes some difficulties that Paxil may present for some. Some have described a feeling of being "high" while on Paxil or "speeded up". Paxil is chemically different than other antidepressants, so it is necessary to use it cautiously, both for many possible potential physical problems, not listed here, but also with regards to the following information,

"During clinical testing in depressed patients, approximately 1% of patients experienced manic reactions. For bipolar patients, the incidence of mania was just over 2%. As with all antidepressants, paroxetine should be used with caution in patients with a history of mania.

Increase in use of medication in treatment of mental health "disorders" from 1993 to 2003.

The most common side effects associated with the use of paroxetine are nausea, drowsiness/sleepiness, sweating, tremor, asthenia (weakness or loss of strength), dizziness, dry mouth, insomnia and male sexual dysfunction (primarily ejaculatory delay). About twice as many patients reported back pain on placebo as on Paxil, and half again as many experienced chest pain on placebo. This could be attributed to Paxil's anti-anxiety effects.

To avoid withdrawal syndrome, Paxil should be tapered off rather than sharply discontinued. Avoid alcohol, as Paxil can cause drowsiness. The risk of fatal overdose is very small with Paxil. As with all SSRIs, long-term use can lead to weight gain.
Purse, Marcia, (June 24, 2008). About.com http://bipolar.about.com/cs/paxil/a/meds_paxil.htm?nl=1

References:

1. Burgess, Wes, M.D., Ph.D., (2006). The Bipolar Handbook. London: Penguin.

2. Carson, R.C., Butcher, J.N. Mineka, S., (2000). Abnormal Psychology and Modern Life. Boston: Allyn and Bacon.

3. Fawcett, J, M.D., Golden, B., Ph.D., (2007). New Hope for People with Bipolar Disorder 2nd edition. New York: Three Rivers Press

4. Mondimore, Francis Mark, M.D. (2006).Bipolar - A Guide for Patients and Families 2nd Edition. Baltimore: The John Hopkins University Press.

5. Purse, Marcia, (June 24, 2008). About.com http://bipolar.about.com/cs/paxil/a/meds_paxil.htm?nl=1