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There are several types of medications for bipolar based on the nature of the symptoms experienced by the patients.
Olanzapine
Olanzapine is an atypical antipsychotic often prescribed as a mood stabilizer, especially for manic or mixed episodes in bipolar disorder. It functions by inhibiting dopamine and serotonin receptors in the brain, leading to reduced symptoms.
Quietapine
Quetiapine is an atypical antipsychotic medium deep used to treat mania, depression, or mixed episode in bipolar disorder. Quetiapine reduces brain excitation by blocking certain neurotransmitter receptors, leading to a calming effect.
Lurasidone
Lurasidone is an atypical antipsychotic, particularly effective in treating depressive episodes in bipolar disorder. It works by modulating dopamine and serotonin receptors, thus stabilizing mood and reducing depressive symptoms.
Desvenlafaxine
Desvenlafaxine is an antidepressant that represents the class of SNRI. It is used to treat depressive episodes in bipolar disorder. It achieves this by inhibiting the reuptake of serotonin and norepinephrine, thus increasing their availability in the brain and improving mood.
Bupropion
Bupropion is a unique antidepressant that acts differently from SSRIs and SNRIs. It is used to treat depressive episodes in bipolar disorder. Bupropion works through the reuptake inhibition of norepinephrine and dopamine.
Lamotrigine
Lamotrigine is an anticonvulsant drug that is an effective mood stabilizer. It is mainly used to treat depressive episodes and is especially useful for patients with frequent episodes. Lamotrigine reduces abnormal brain activity by inhibiting sodium channels and stabilizing overexcited neurons.
Valproate
Valproate is a mood stabilizer that is widely used to treat mania or mixed episodes in bipolar disorder. Valproate works by increasing the level of gamma-aminobutyric acid in the brain, an important inhibitory neurotransmitter that reduces brain activity.
The supplies that are needed for medications for bipolar mainly focus on ensuring proper and adequate dosage, safety, and compliance for the patient.
Blister Packs for Mood Stabilizers and Anticonvulsants
The mood stabilizers and anticonvulsants such as lamotrigine and valproate are commonly packaged in blister packs. The individual sealing of each tablet within the blister gives visibility to the dose and protects the tablets from environmental factors.
Tightly Sealed Containers for Antipsychotics
Antipsychotic medications such as olanzapine and quetiapine are commonly packaged in tightly sealed containers, often with protective inner seals. Antipsychotic medications are sensitive to moisture and light and therefore require containers that have high resistance to these two elements.
Child-Resistant Packaging
Child-resistant packaging for all psychoactive medications is important to prevent accidental ingestion by children and pets. Such packaging is mandatory in many jurisdictions by law.
Lamotrigine
Lamotrigine is used as a mood stabilizer in bipolar patients. It has to be administered by mouth in the form of tablets and its dosage has to be based on the patient’s medical status and whether or not they are on co-medications.
Valproate
Valproate is taken orally and is available in delayed-release and extended-release forms. Patients have to be closely monitored for possible adverse effects like gastrointestinal disorders and tremors.
Olanzapine
The initial doses of olanzapine for adult patients should not exceed 15 mg and should be lower in patients with liver disorders and in geriatric patients. The doses should be adjusted depending on the therapeutic response and the tolerance levels of the patient.
Pregnancy and Lactation
Antidepressants such as desvenlafaxine and bupropion pose potential risks during pregnancy. It is advised that the prospective benefits be weighed against possible fetal harm before administration. Antipsychotics such as olanzapine and quetiapine also have possible risks during pregnancy.
Kidney and Liver Impairment
Patients with kidney or liver impairment may require lower doses of SNRIs such as desvenlafaxine and bupropion because these drugs are primarily excreted through the kidney and metabolized by the liver, respectively.
Drug Interactions
Antidepressants can interact with other drugs and therefore are not to be used on patients who are on other drugs such as monoamine oxidase inhibitors, blood thinners, or seizure medications without prior consultation with a healthcare professional.
Bipolar medications are mostly used in clinical settings, but at times they can also be self-administered in daily life to stabilize moods.
Assessment and Diagnosis
Bipolar medications are diagnosed through mood assessment charts and interviews with healthcare personnel who identify the type of bipolar disorder the patient has and recommend the right treatment. This is an important step because the medications can only be effective if they are administered according to the diagnosis.
Treatment Plan Development
After diagnosis, the primary healthcare physician develops a treatment plan that incorporates the type of medication for bipolar disorder that the patient will take and the kind of therapy the patient will undergo.
Monitoring and Follow-Up
Regularly going for checkups is critical for patients on bipolar medications as the healthcare professionals monitor the patient for side effects and measure the efficacy of the medication. They then modify the treatment as per the observations they make on the patient’s response and the side effects experienced.
Severe Mania or Psychosis
During manic or psychotic episodes, individuals may pose a danger to themselves or others. Emergency medications like benzodiazepines or antipsychotics are required to calm them down and stabilize their mental state. These are then administered in emergency care in the healthcare facilities.
Substance Abuse or Self-Harm
Some patients may result in substance abuse or self-harm as a way of coping with the disorder. Immediate medical attention is needed to manage their withdrawal symptoms or suicidal ideation. In such cases, healthcare providers focus on stabilizing the patient with antipsychotics or mood stabilizers.
Medical Clearance before Inpatient Treatment
Patients in emergency situations who require inpatient treatment must be evaluated and stabilized medically before they can be treated with medications. Healthcare providers manage acute symptoms and ensure the patient is stable enough for further treatment.
Self-Management with Medication
In daily life, patients with bipolar disorder who are on treatment take their medications as per the prescriptions they were given. Most of the medications are in the form of tablets that are taken daily at the same time for effective mood stabilization.
Mood Tracking and Adjustments
Patients often use mood tracking apps or journals to track their moods and spot any possible changes. This enables them to know when to adjust their medications and consult with their doctors fast.
Therapeutic Coping Strategies
Patients engage in therapeutic coping strategies that help them deal with stress, potential triggers, and mood episodes. Patients use medications and coping mechanisms in their daily lives to minimize the impact of bipolar disorder on their functioning.
When choosing bipolar medications, several factors should be considered to achieve optimal and safe treatment for the patients.
Bipolar I
Bipolar I is characterized by at least one manic episode, with possible depressive episodes. People with this condition often benefit from antipsychotic medications during mania, and medications for depression may be needed during the depressive phases.
Bipolar II
Bipolar II has hypomanic and depressive episodes. Their treatment focuses more on stabilizing moods and managing extreme highs or lows. Antidepressant medications like desvenlafaxine and bupropion may be useful in this type of bipolar.
Cyclothymia
Patients with cyclothymia have mild and intermittent periods of hypomania and depression. They benefit from medications that are commonly used in bipolar I and II, focusing on stabilizing their more moderate mood swings.
Manic Symptoms
During manic symptoms, patients can become excessively irritable, euphoric, or restless, and sometimes engage in risky behavior. It is important to choose medications for mania, such as mood stabilizers and antipsychotics, to lessen these symptoms.
Depressive Symptoms
Patients with depressive symptoms have low energy and feelings of worthlessness and become detached from reality. Antidepressants and mood stabilizers are effective in treating patients who are experiencing depressive symptoms.
Mixed Episodes
Mixed episodes have both manic and depressive symptoms simultaneously, and this can be very challenging to treat. Medications like atypical antipsychotics are effective in stabilizing the patient’s mood and reducing the severity of mixed symptoms.
Olanzapine
Common side effects of olanzapine are weight gain, drowsiness, and metabolic changes that may increase the risk of diabetes or cardiovascular diseases. Other rare but serious side effects are extrapyramidal symptoms and tardive dyskinesia.
Quetiapine
Drowsiness, dry mouth, and dizziness are the most common side effects of quetiapine. Quetiapine can also cause metabolic side effects like increased appetite and weight gain.
Lurasidone
Increased risk of akathisia, restlessness, and agitation are the most common side effects of lurasidone. Other possible side effects are insomnia and extrapyramidal symptoms.
A1. The choice of medication generally depends on the specific type of bipolar disorder and the symptoms that the patient is experiencing, but they all commonly use mood stabilizers like lithium.
A2. The newly-approved medication for bipolar disorder is caplyta, which was approved in 2020. Caplyta treats patients who have manic episodes or mixed episodes with an autonomic failure of depression or mania associated with it.
A3. Lurasidone is the least sedating because, although it causes agitation and insomnia in some patients, most patients do not feel drowsy because it causes minimal sedation and carries the risk of extrapyramidal side effects.
