What is Biploar Disorder?
Bipolar or manic depressive illness is a brain disorder that causes a typical changes in mood, energy and activity levels. Bipolar 1 disorder is diagnosed as having manic or mixed episodes, which are not normal of the person's behaviour. The episodes last for at least a week and require medical attention. The person also experiences depressive episodes, which last approximately two weeks. In between the cycling of manic and depression, many can live normal lives. Symptoms first appear in teens or early 20s, with many developing the disorder before the age of 50.
Bipolar Disorder Medications
Many different medications are needed for the best course of treatment as patients respond to the drugs differently. The medication should be taken continuously for the prevention of a relapse. Manic episodes in bipolar I disorder require treatment with drugs, such as antidepressants, mood stabilizers, benzodiazepines, and newer antipyschotics.
To track and treat the illness, the patient carries out a daily life chart of their mood symptoms, treatments, sleeping patterns and life events. Usually, the first choice of treatment is the long term use of mood stabilisers. With the exception of lithium, they are anticonvulsants to treat seizures as well as controlling mood. There are many types of mood stabilisers on the market. Lithium was the first to be approved by the U.S. Food and Drug Administration (FDA). It is frequently effective in controlling the symptoms of mania, and preventing the recurrence of manic and depressive episodes.
Valproic acid is as effective as lithium for treating mania. Lamotrigine is the more recent for maintaining the treatment. Less prescribed anticonvulsants include gabapentin, topiramate and oxcarbazepine as they are not more effective than the mood stabilisers. It is thought that by taking valproic acid, lamotrigine and other anticonvulsants, it increases the risk of suicidal thoughts and behaviours and therefore patients are closely monitored.
In addition to the disorder, patients often have problems with their thyroid gland. The overproduction or underproduction of the thyroid hormone can lead to mood and energy changes. It has been seen that hypothyroidism is associated with the rapid cycling of the bipolar disorder, occurring especially in women.
Atypical antipsychotic drugs are often used for treatment. They are usually taken with other drugs. These include: olanzapine, which is given with an antidepressant to help relieve symptoms of severe mania or psychosis. It can also be given intravenously to treat agitation of manic or mixed episodes. Aripiprazole has the same effect as olanzapine as well maintaining treatment after a severe or sudden episode. Quetiapine relieves the symptoms of severe and sudden manic episodes. Risperidone and ziprasidone are also prescribed for controlling manic or mixed episodes.
Other treatments include:
Psychotherapy to educate, support and provide guidance to people with the disorder and their families. A study carried out by NIMH had found that patients that were treated with medication and extensive psychotherapy, underwent fewer relapses, fewer admissions to hospitals, and were able to stick to treatment plans.
Electroconvulsive therapy is used to treat severely depressive, manic or mixed episodes. It is not usually given as a first line of treatment.
