There are a variety of medications used in the management of bipolar depression, and they vary from situation to situation, doctor to doctor, patient to patient. Typically, at least two drugs will be prescribed: one to control the depression, and one to control the mania (or hypomania as the case may be). However this is typically the minimum medication regime needed for managing the condition. People with bipolar often find themselves with several daily medicines to control the disease itself as well as related problems like sleep and other conditions.
Antidepressants on their own are not a good idea for treating bipolar, as they can trigger manic episodes (or worse, ultra-rapid cycling) if they are not taken concurrently with a mood stabilizer. Therefore, if a bipolar person is misdiagnosed as having “ordinary” unipolar depression, there are significant risks.
A complete management plan is necessary. Mood stabilizers are your first line of defense against your mood swings. They work to control or stop manic episodes.
The original mood control medication is lithium (in name brands such as Lithobid and Eskalith). In addition to lithium, there are other medications that are used to help stabilize the mood. Anti-seizure medications in particular actually provide the help that’s needed. These include medications like valproic acid with the brand name of Depakene. Divalproex, Iamotrigine are others. A less commonly used anti seizure medication is Topiramate which is sold as Topamax.
However, mood stabilizers are only one part of a treatment plan. Antidepressants are used for treating depression and therefore often work with bipolar patients. These include the following as well as others not in this list:
•Paraxetine which is marketed as Paxil
•Buprpion which is marketed as Wellbutrin
•Fluoxetine which is marketed as both Proza and Sarafem
•Sertraline which is marketed as Zoloft
Because manic depressive people often have problems getting to sleep, medications such as clonazepam (brand name Klonopin®) or lorazepam (brand name Ativan®). These drugs can be habit forming, so they are often only prescribed for the short term. Sedatives such as as zolpidem (Ambien®) are sometimes also used, as these are less habit forming.
Bipolar has high comorbidity with other conditions such as attention deficit hyperactivity disorder (ADD or ADHD). There are several medications available to treat ADHD, but many of these are stimulants which can be habit-forming, and create a risk of mania. For this reason, non-stimulant ADHD medications such as Strattera are preferred.
Medication in combination with lifestyle changes is the most effective way of managing manic depression in the long term. For more information see our article on lifestyle strategies to beat bipolar.