Short Term Treatment for Symptoms of Bipolar Disorder
Bipolar disorder affects the neurotransmitters of the brain (nerve cells that transmit signals), causing emotions and emotional responses to short circuit. This mental illness is able to lie dormant for a long time, even decades before striking the victim with sudden mania or a bout of extreme depression.
People who have bipolar disorder can be severely depressed and completely unable to find a way out of their sadness. Often such depression can lead to the patients attempting to hurt themselves and 15% will even commit suicide. If the illness is left untreated the depression will remain and become a danger to the victim and others. Symptoms of bipolar depression vary, but include:
Sleep disruption - insomnia or hypersomnia (sleeping too much).
Significant changes in body weight - increase or decrease.
Inability to feel pleasure or happiness.
Periodic loss of short-term memory.
Inability to focus and concentrate.
Feeling worthless and sad.
Withdrawing from others.
Loss of sex drive.
Feeling agitated.
Indecisiveness.
Feeling guilty.
Constipation
Headaches
Fatigue
Bipolar Psychosis and Treatment
In this state the symptoms of bipolar disorder are:
Delusional thoughts.
Hallucinations.
Catatonia
Without treatment or intervention during this extreme stage, the patient will die. Acute phase bipolar disorder treatment deals specifically with ending the current manic, hypo-manic or depressive state. The components of acute phase bipolar disorder treatment include medication, education and psychotherapy. There are three important medications that are used to treat bipolar disorder symptoms: mood stabilizers, antidepressants and antipsychotics.
Mood Stabilizers for Bipolar Depression
Mood stabilizers must have two main properties:
Relieve acute mania or depression; prevent episodes from recurring.
Not exacerbate symptoms or lead to an increase in cycling.
Lithium, divalproex and carbamazepine are three mood stabilizers. Lithium and divalproex are well known and widely used. Divalproex and carbamazepine started out as anticonvulsants. There are other types of medicines being researched for use as mood stabilizers including anticonvulsants and “atypical” antipsychotics. Another treatment used for treating bipolar disorder is Electroconvulsive Therapy (ECT) but it is not as widely used as the chemical medications.
Antipsychotics for Bipolar Depression Treatment
Various drugs are used to treat different aspects of bipolar disorder. If the patient is having delusions or hallucinations from a severely manic episode, antipsychotic medications can be useful. Antipsychotics can be used for sedation sedatives early in treatment, insomnia, anxiety and agitation. Newer antipsychotic medications are believed to work well as mood stabilizers.
Patients who have not had psychotic symptoms sometimes benefit from antipsychotic medications because they improve patient response to mood stabilizers. Some patients do not handle the typical mood stabilizers well or respond to them so antipsychotics may be used alone to stabilize their mood.
There are two types of antipsychotics: typical/conventional antipsychotics (older drugs) and atypical antipsychotics (newer drugs). Conventional antipsychotics come with the risk of tardive dyskinesia (TD) (a permanent movement disorder), muscle stiffness, restlessness and tremors. Atypical antipsychotics come with a lower risk of TD (1% of patients) as well as other side effects. Since they are viewed as safer, atypical antipsychotics are the first line of defense against psychosis.
The most commonly used atypical antipsychotics are:
olanzapine (Zyprexa)
quetiapine (Seroquel)
risperidone (Risperdal)
clozapine (Clozaril)
Most people who have side effects from atypical antipsychotics suffer from drowsiness and weight gain. Clozapine is usually the primary medicine of this group because one of its side effects is a rare but serious blood disorder that requires regular blood tests.
Antidepressants for Bipolar Depression Treatment
Antidepressants are combined with mood stabilizers to treat depression symptoms. Antidepressants must be used with a mood stabilizer to keep the patient from switching over to a mania episode. There are various antidepressants available and they have a wide range of side effects. Depression is often seen as something separate from mania so most of the research on antidepressant medications has been done on unipolar depression, without considering the effect it would have on a manic episode. Even with so little research on bipolar disorder and antidepressant medication, most research suggests that antidepressants are very effective in treating bipolar disorder when used with mood stablizers.
When the primary types are ineffective or cause unpleasant side effects, other choices are:
Mirtazapine (Remeron).
Nefazodone (Serzone)
Monoamine Oxidase Inhibitors (MAOI): phenelzine (Nardil), tranylcypromine (Parnate). These require a special diet to avoid dangerous side effects.
Tricyclic Antidepressants: amitriptyline (Elavil), desipramine (Norpramin, Pertofrane), imipramine (Tofranil), nortriptyline (Pamelor). Tricyclics can cause additional side effects like manic episodes or rapid cycling.
