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Bipolar disorder

Explains what bipolar disorder is, as well as different diagnoses and treatments. Offers information on how you can support someone with bipolar and tips for self-management.

What will my doctor need to know?

To help decide which medication to offer, your doctor might need to look into factors such as:

  • Your current symptoms. For example, if you're currently experiencing a manic, hypomanic, depressive or mixed episode.
  • Your past symptoms. Such as the types of mood episodes you have experienced, and how long they have lasted.
  • How you've responded to treatments in the past.
  • The risk of another episode. This could include what has triggered episodes in the past.
  • Your physical health. In particular if you have kidney problems, weight problems or diabetes.
  • How likely you are to stick to a medication routine.
  • Your sex and age. In particular whether you are able to become pregnant.
  • In older people, a test of mental processes. For example, the test used to diagnose dementia.

Before you take any medication

Before you decide to take any medication, make sure you have all the facts you need to feel confident about your decision.

For guidance on what you might want to know before taking any medication, see our pages on:

Antipsychotics for bipolar disorder

If you're currently experiencing a manic or hypomanic episode, your doctor is likely to prescribe you an antipsychotic.

Your doctor is also likely to prescribe antipsychotics if you experience psychotic symptoms in an episode of mania or severe depression.

The National Institute for Health and Care Excellence (NICE) – the organisation that produces guidelines on best practice in healthcare – recommends the following antipsychotics:

  • haloperidol – also known as Dozic, Haldol, Haldol Decanoate, Serenace
  • olanzapine – also known as Zalasta, Zyprexa, ZypAdhera
  • quetiapine – also known as Atrolak, Biquelle, Ebesque, Seroquel, Tenprolide, Zaluron
  • risperidone – also known as Risperdal, Risperdal Consta

If your first antipsychotic doesn't work, your doctor might offer another from the list above. If the second doesn't work, your doctor might offer lithium to take together with an antipsychotic.

If you take an antipsychotic, you'll need to have regular health checks with your doctor.

For more information, see our pages on antipsychotics.

Lithium for bipolar disorder

Your doctor might prescribe lithium as a long-term treatment for bipolar disorder. It can help to:

It’s typically a long-term treatment, usually prescribed for at least six months.

For lithium to be effective, the dosage must be correct. You'll need regular blood and health checks while taking lithium, to make sure the levels are right for you.

For more information, see our page on lithium.

I was really quite unwell. Then my psychiatrist changed my medication. I began taking lithium and it really worked for me. I started feeling better pretty quickly.

Anticonvulsants for bipolar disorder

Three anticonvulsant drugs, used as mood stabilisers, are licensed to treat bipolar disorder:

  • carbamazepine – also known as Tegretol. This is sometimes prescribed to treat episodes of mania. It can be prescribed if lithium is ineffective or unsuitable for you. For more information, see our page on carbamazepine.
  • valproate – also known as Depakote, Epilim. This can be used to treat episodes of mania and is typically a long-term treatment. It can be prescribed if lithium is ineffective or unsuitable for you. Your doctor is unlikely to prescribe you valproate if you're able to become pregnant. This is because it can lead to significant risks in pregnancy. The Medicines and Healthcare products Regulatory Agency (MHRA) is updating its recommendations on the use of valproate. But if you’re currently taking valproate, it’s important to continue taking it unless your doctor tells you otherwise. For more information, see our page on valproate.
  • lamotrigine – also known as Lamictal. This is licensed to treat severe depression in bipolar disorder, but NICE does not recommend it for treating mania. If you're pregnant and taking lamotrigine, NICE recommends regular check-ups. For more information, see our page on lamotrigine.

For more information, see our pages on mood stabilisers.

Medication can help keep your moods on an even keel, but it is trial and error.

Antidepressants for bipolar disorder

Your doctor might offer you a type of antidepressant medication, such as selective serotonin reuptake inhibitors (SSRIs). Antidepressants might be offered in combination with one of the medications described above.

Remember: always check with your doctor or pharmacist before taking any medications together, or closely following one another. The medications could interact badly with each other.

For example, combining lithium with SSRIs can increase the risk of side effects like serotonin syndrome.

For more information, see our pages on antidepressants.

It took me almost 11 years of living with the disorder before I found the right medication to keep my episodes at bay, and my moods properly stabilised.

This information was published in February 2022. We will revise it in 2025.

References and bibliography available on request.

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