How much longer varies from person to person. Mood stabilizers can help prevent further episodes of mania or depression. In other words, staying on these medications for the long term can help to keep you well. Going off mood stabilizers, on the other hand, can greatly increase your chances of having another episode. Talk to your doctor if you would like to try this. Drugs that are addictive produce a feeling of euphoria, a strong desire to continue using the drug, and a need to increase the amount used to achieve the same effect.
Mood stabilizers do not have these effects. While mood stabilizers are not addictive, when you take them or any drug over months or years, your body adjusts to the presence of the drug. If you then stop using the drug, especially if you stop suddenly, the absence of the drug may result in withdrawal effects or in return of symptoms. With mood stabilizers, the withdrawal effects are generally mild; the greatest risk with stopping these drugs is the return of symptoms.
Whether you want to cut down your dose or stop taking a medication, the same rule applies: go slowly. Sudden changes in your dose can greatly increase your risk of having another mood episode. The first step is to ask yourself if this is the right time.
Are you feeling well? Is the level of stress in your life manageable? Do you feel supported by your family and friends? If you are not satisfied with his or her reasons, you may want to see another doctor for a second opinion. If your doctor does agree, he or she will advise you not to skip doses but to reduce your dose gradually over a four to six week period.
This process of cutting back will take several months. If you want to stop taking more than one medication, your doctor will usually suggest that you lower the dose of one drug at a time. As you cut down, if you start to feel unwell, let your doctor know. You may want to go back up with your dose. Find the dose that works best for you. Some medications can affect the blood levels of mood stabilizers, meaning your dose of mood stabilizer may have to be adjusted while you are taking the other medication.
Mood stabilizers, especially carbamazepine, may also reduce the effectiveness of some other drugs. Always make sure your doctor or dentist knows about any drugs you are taking when he or she prescribes another medication. Drinking coffee or other beverages that contain caffeine can lower lithium levels and increase tremor.
If you want to dramatically change how much caffeine you have in a day e. People with bipolar disorder are generally advised to avoid alcohol. This is recommended because:. While avoiding alcohol is the best choice for many people with bipolar disorder, having a drink or two on occasion should be okay for those who are stable, feeling well and who have not had a substance use problem. Street drugs can complicate your situation and create problems. Cocaine and amphetamines, for example, can trigger an episode of mania or depression.
Marijuana could lift you up or it could bring you down; its effects on mood can be unpredictable, especially when combined with bipolar disorder. Using any street drugs or alcohol regularly to modify your mood increases your risk of addiction.
Mood stabilizers, especially early in treatment, may delay your reaction time. This effect could impair your ability to drive a car or operate other machinery. Avoid these activities until you adjust to the medication or if you feel slowed down. Taking lithium may reduce your interest in sex. This can be a good thing for some people and not so good for others. If you feel your interest in sex is too low, talk to your doctor about it. Sometimes an adjustment in dose can help.
Although not common, some men who take lithium report a decreased ability to maintain an erection or to ejaculate. With bipolar disorder, many complex factors other than medication may contribute to sexual difficulties. In women, mood stabilizers may cause changes in the menstrual cycle. Carbamazepine and other anticonvulsants may reduce the effectiveness of birth control pills.
For any pregnant woman with a history of bipolar disorder, the question of taking mood stabilizers during pregnancy usually comes down to a risk-benefit analysis. When treatment with a mood stabilizer helps to avoid a relapse or to reduce distress, the benefits may outweigh the risks. Lithium can also help bipolar depression. However, it is not as effective for mixed episodes or rapid cycling forms of bipolar disorder. Lithium takes from one to two weeks to reach its full effect.
Doses that are too high can be toxic. When you first start taking it, your doctor may check your blood levels once or twice a week. Even taking a different brand of lithium can lead to different blood levels. Keep a steady salt intake.
Do not suddenly reduce the amount of salt in your diet. Drink plenty of fluids 8 to 10 glasses of water every day , more in hot weather or if you exercise heavily.
Keep your caffeine intake steady. Reducing caffeine can cause your lithium level to increase, while adding more caffeine can cause your lithium level to decrease. Always tell any doctor or pharmacist that you are on lithium before taking any new medicines. Originally developed for the treatment of epilepsy, anticonvulsants have been shown to relieve the symptoms of mania and reduce mood swings.
Valproic acid, also known as divalproex or valproate, is a highly effective mood stabilizer. Common brand names include Depakote and Depakene. Valproic acid is often the first choice for rapid cycling, mixed mania, or mania with hallucinations or delusions.
Although antidepressants have traditionally been used to treat episodes of bipolar depression, their use is becoming more and more controversial. A growing body of research calls their safety and efficacy into question. A major study funded by the National Institute of Mental Health showed that adding an antidepressant to a mood stabilizer was no more effective in treating bipolar depression than using a mood stabilizer alone. Another NIMH study found that antidepressants work no better than placebo.
Antidepressants can trigger mania in people with bipolar disorder. If antidepressants are used at all, they should be combined with a mood stabilizer such as lithium or valproic acid. Taking an antidepressant without a mood stabilizer is likely to trigger a manic episode. Antidepressants can increase mood cycling.
Many experts believe that over time, antidepressant use in people with bipolar disorder has a mood destabilizing effect, increasing the frequency of manic and depressive episodes. The new focus in bipolar depression treatment is on optimizing the dose of mood stabilizers. If you can stop your mood cycling, you might stop having depressive episodes entirely. If you are able to stop the mood cycling, but symptoms of depression remain, the following medications may help:.
DO NOT stop taking your antidepressant suddenly, as this can be dangerous. Talk to your doctor about slowly tapering off the antidepressant. The tapering process should be done very slowly, usually over the course of several months, in order to reduce adverse withdrawal effects. If you lose touch with reality during a manic or depressive episode, an antipsychotic drug may be prescribed. They have also been found to help with regular manic episodes.
Antipsychotic medications may be helpful if you have tried mood stabilizers without success. Often, antipsychotic medications are combined with a mood stabilizer such as lithium or valproic acid. Sexual and erectile dysfunction is a common side effect of antipsychotic medications, one that often deters bipolar disorder patients from continuing medication.
However, a study in Vellore, India concluded that the medication Sildenafil citrate Viagra is safe and effective in the treatment of antipsychotic-induced erectile dysfunction in men.
Other medications your doctor may recommend include benzodiazepines, calcium channel blockers, and thyroid medications. Mood stabilizers can take up to several weeks to reach their full effect. Benzodiazepines are fast-acting sedatives that work within 30 minutes to an hour.
Because of their high addictive potential, however, benzodiazepines should only be used until your mood stabilizer or antidepressant begins to work.
Those with a history of substance abuse should be particularly cautious. Traditionally used to treat heart problems and high blood pressure, they also have a mood stabilizing effect. They have fewer side effects than traditional mood stabilizers, but they are also less effective.
The article reports that lithium is especially effective at reducing the risk of suicide among people with bipolar disorder who had not received treatment. It is one of the most effective treatments for bipolar disorder. The author of the CNS Drugs article cited a study in which one-third of the 60 participants who took lithium to treat their symptoms had no manic or depressive episodes in the following 10 years. The author points out that lithium primarily helps reduce mania, but it can also help improve depression.
According to study findings published in World Psychiatry , lithium was more effective than other mood stabilizers at treating symptoms of bipolar disorder. The authors also found that lithium reduced the chances of a person with bipolar disorder needing supplementary medication, thus lowering the overall risk of unwanted side effects. According to results of a study from , published in the journal BMC Psychiatry , carbamazepine is also very effective at treating the symptoms of bipolar disorder.
A doctor might prescribe carbamazepine if a person has not responded well to lithium. Alternately, a person may take carbamazepine alongside lithium or other mood stabilizers. According to a review in the Cochrane Database of Systematic Reviews , valproate may effectively treat the symptoms of bipolar disorder — especially over the longer term. If a person experiences multiple side effects of lithium, or if lithium is not very effective, they may want to consider valproate, either instead of lithium or alongside it.
Research into the effectiveness of atypical antipsychotic drugs is still sporadic. Some new drugs show promise as treatments, but further research is necessary. According to a review in the International Journal of Neuropsychopharmacology , atypical antipsychotic drugs could help treat manic episodes, and there is some evidence that they may treat depressive episodes as well.
Lamotrigine is an anticonvulsant drug that doctors have — relatively recently — recommended as a key treatment for the symptoms of bipolar disorder.
A review in the journal Frontiers in Pharmacology concluded that lamotrigine was effective at treating these symptoms. However, because it is a relatively new drug for bipolar disorder, scientists need to do more research to find out how effective it can be. They also need to determine whether a person should take it as a monotherapy or in combination with other drugs. We explain its pros and cons, and what you should….
Whether you have bipolar disorder or are dating someone with the condition, learn what you can do to maintain a healthy and fulfilling relationship. Bipolar disorder can affect your day-to-day life, but what are the long-term effects of the drugs used to treat it? Understanding the signs and triggers of your bipolar disorder episodes can help you better manage your symptoms. Health Conditions Discover Plan Connect. What are mood stabilizers?
How do mood stabilizers work for bipolar depression? Is there such a thing as homeopathic mood stabilizers? What are the side effects of mood stabilizers? Can I get over-the-counter mood stabilizers? Effects of Bipolar Disorder on the Body.
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