For those who are diagnosed with
bipolar disorder, drug treatment in the form of
mood stabilizers (such as lithium), antipsychotics, both
atypical (such as Zyprexa) and typical (such as Chlorazin), are usually prescribed. Antidepressants may also be prescribed by some psychiatrists or
medical doctors. This page provides some details and a general idea of the specific and types of medications which are often prescribed for bipolar disorder, and the type of side effects which most experience.
It should be realized, that with the exception of many
SSRI antidepressants, drugs for the treatment of bipolar disorder, generally slow down the mental and physical functioning of the body. Antipsychotics and
mood stabilizers of all genres generally cause drowsiness or extreme drowsiness in some clients.
A psychologist cannot prescribe medications/drugs, but only a
psychiatrist. Sometimes pediatricians will presribe drug treatment for children, even infants. It should be noted that this is a very controversial in
psychiatry, and not all doctors agree with giving young children, children, and even teens, strong
antipsychotic and
mood stabilizing drugs.
Further, many
teens and children, as well as adults, are prescribed four to six different
psychiatric medications at one time. The side effects intensify with each new drug, and some are rendered incapacitated, not from the psychiatric condition, but from the strong side effects of the
psychiatric drugs.
Short term and long term memory loss have been experienced by some psychiatric clients as a result. The long-term effects on children, teens or adults are not fully known at this time, as there are not enough long-term clinical studies to draw accurate conclusions.
Even
lithium can cause lethargy, emotional dulling, and may not fully address the issues for which it is prescribed.
At best, psychiatric drugs for
bipolar disorder hold symptoms at bay, or relieve some symptoms. However, side effects are so distressing for some, that many choose not to stay on the medications.
With that in mind, those who display
symptoms of bipolar disorder, should think seriously about what
lifestyle changes can be made in their life, which can and does help to alleviate some or many of the symptoms that may be experienced with a bipolar diagnosis.
This page should give the reader a general idea of the psychiatric drugs used in treating
bipolar disorder.
Lithium
mood stabiilzer
Lithium-side effects and possible complications:
5-35% develop depression of thyroid gland functioning (hypothyroidism) - (treated w/thyroid replacement meds)
Can cause an increase in mood cycling.
(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 (Sodium Valporate)
anticonvulsant/ mood stabilizer
Used to treat epileptic seizures and bipolar disorder
Valporate has a milder side-effects profile than lithium. (Ibid, p.94)
Valporate can sometimes can lead to liver problems. p. 95
"Birth defects" when taken by pregnant women. (Ibid, p.95).
"[M]any newer medications [such as Valporate] don't seem to be more effective than available older ones when studied in large groups of patients." (Ibid, p.96)
Tegretol (carbamazepine)
anticonvulsant/ mood stabilizer
One well-designed study concludes that
(Tegretol) and similar medications have less success in alleviating
symptoms of bipolar disorder than lithium. It is therefore recommended as a secondary medication rather than as a first line treatment.
Side effects for Tegretol can be, again, "sleepiness, light-headedness, some initial nausea," as well as other physical side effects. (Ibid).
Carbamazepine (Equetro, Tegretol, Carbatrol, others) are used for
bipolar disorder and
epilepsy are
sedating to "
mildly sedating." (Burgess, W., p.78)
Risperidone(Risperdal)
atypical antipsychotic
Used to treat -
schizophrenia
schizoeffective disorder
bipolar disorder
Mixed results from
psychiatrists using risperdal to treat bipolar disorder.
"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 (divalproex sodium) - Depakene (Valporic Acid)
antiseizure medication -
Depakote and Depakene are used for both bipolar disorder and seizures.
Many meds used for bipolar disorder are also used for epilepsy.
Clozaril (clozapine)
sedative - typical antipsychotic
used since the 1960s for treamtne of schizophrenia
"Very sedating"
"Can cause blood problems." (Fawcett, Golden).
Clozaril Side Effects (off-site)
Sedatives
Studies have shown that sedatives can make people "more irritable and angry even without their realizing."
Sedatives can also be "addictive," difficult withdrawal. (Burgess, W. p.95)
Dr. Wes Burges does not recommend sedatives such as Xanax (alprazolam) Iorazenar (Ativan) Clonazepam (Klonopin) and Diazepam (Valium) for bipolar disorder.
Zyprexa (olanzapine)
atypical antipsychotic
Zyrexa is described as the best
atypical antipsychotic. "However it is sedating." P. 93
Sedating
Weight gain and diabetes have been issues with Zyprexa. (Burgess)
Diabetes (some resultant deaths).
[There have been lawsuits of late with use of Zyprexa in connection with diabetes].
Seroquel (quetiapine fumarate)
atypical antipsychotic
Seroquel is "sedating".
Conclusion from Dr. Burgess, Golden and Mondimore's works on medications used in treatment of bipolar disorder.
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
(SSRI antidepressant)
Paxil Can Contribute to Mania for those with bipolar disorder or Depression
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 (Paxil) 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 (Paxil) 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. [5]
References for Facts on Bipolar Disorder Treatment
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
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