Monday, July 8, 2013

Meds for Bipolar Disorder

Bipolar disorder can't be cured and can be difficult to diagnose. After it is identified, however, it often can be treated successfully.

Taking medicine for bipolar disorder is not like periodically taking an aspirin for a headache or a decongestant for allergy. Bipolar meds are swallowed several times a day on a daily basis, year after year. Once I decided to skip a daily dose of a prescribed bipolar medicine, and soon I became suicidal. After I resumed taking the pill I'd skipped, I had not the slightest ghost of an attraction to suicide. One pill a day made the difference between wanting to live and wanting to die.

Bipolar people who don't respond to medicine may find electroconvulsive therapy or transcranial magnetic stimulation helpful. A bipolar Ivy League professor has written that his career, his marriage, and his life were saved by shock treatment. Today patients are anesthetized while the electric shocks are administered. When they awake, they may have minor memory problems that soon disappear, but the cruel fate of Jack Nicholson in the 1975 classic, "One Flew Over the Cuckoo's Nest," is not an issue today.

One danger of being bipolar but undiagnosed is giving in to an urge to self-medicate with alcohol. Alcoholics Anonymous is a resource, but to get to the point where they can stop drinking, bipolar alcoholics may need to be diagnosed and treated as bipolar first.

A psychiatrist can provide a bipolar diagnosis. For treatment, psychiatric nurses, psychologists, and individual or family support groups may also be involved. Even after bipolarity is diagnosed and treated, at its most extreme, it may lead to periodic hospitalization for bipolar 1 patients.

There is no one-size-fits-all treatment or prescription for bipolar disorder. A psychiatrist and patient may try several solutions before hitting on one that works. As for medicine, Librium was the first to be widely used. But a bipolar friend of mine was allergic to Librium before there were other drugs available. She tried to commit suicide only once, and she was discovered and saved, but daily living required a degree of valor that few of us have to face. Luckily she had a keen joy in life, which may have been related to bipolar hypomania.

Today there are dozens of medications used to treat bipolar disorder. There are also a wide variety of side effects.

Meds include anticonvulsants like Depakote, probably because the part of the brain that houses bipolarity is close to the area where seizures arise. One such drug is quetiapine (Seroquel), the only one approved the U.S. Food and Drug Administration (FDA) for treating bipolar disorder.

Antidepressants are sometimes prescribed for bipolar people, which seems like a no-brainer given that depression is a symptom of bipolarity. But an antidepressant may go too far and trigger a manic episode. Antidepressants may also cool your sex drive. If sex is important you, I'd think a lowered sex drive might be depressing and take you back to where to started. Other side effects might be not only undesirable but also downright dangerous, so a patient should be carefully monitored while on antidepressants.

The anti-anxiety medications Xanax, Valium, and Librium are popular with people who are not bipolar as well as those who are, probably because anxiety is a hallmark of our times. Drowsiness, memory loss, and poorer muscle coordination are the down side.

Being bipolar is not without challenges, but more help is available today than ever before.

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