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Explains what bipolar disorder is, what kinds of treatment are available, and how you can help yourself cope. Also provides guidance on what friends and family can do to help.
If you are diagnosed with bipolar disorder, it’s likely that your psychiatrist or GP will offer to prescribe medication. This might include:
Which medication you are offered will depend on:
You are most likely to be prescribed an antipsychotic if you have an episode of mania or severe depression in which you experience psychotic symptoms, such as hearing voices. However, some antipsychotics are increasingly prescribed even if you haven't had psychotic symptoms, as their side effects might be less unpleasant, and they're safer in pregnancy.
The National Institute for Health and Care Excellence (NICE) treatment guidelines recommend the following antipsychotics:
If your first antipsychotic doesn't work, you should be offered a different one from the list above. If the second antipsychotic doesn't work you may be offered lithium to take together with an antipsychotic.
If you're prescribed an antipsychotic, you'll need to have regular health checks with your doctor.
(See our pages on antipsychotics for more information about these drugs, including potential side effects.)
Lithium can be effective for reducing the likelihood of:
It is typically a long-term method of 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 your lithium levels are right for you.
(For more information, see our page about lithium.)
"Lithium helps [me cope] and I just have to keep reminding myself that whichever feeling I’m going through won't last forever."
There are three anticonvulsant drugs used as mood stabilisers which are licensed to treat bipolar disorder:
Carbamazepine (Tegretol) is also sometimes prescribed to treat episodes of mania. It can be prescribed if lithium is ineffective or unsuitable for you.
Valproate (Depakote, Epilim) can be used to treat episodes of mania and is typically a long-term method of treatment. It can be prescribed if lithium is ineffective or unsuitable for you. However, if you could become pregnant your doctor shouldn't offer you valproate unless there is a pregnancy prevention programme in place, as it carries significant risks to your baby.
Lamotrigine (Lamictal) has antidepressant effects and is licensed to treat severe depression in bipolar disorder. NICE guidelines recommend that it is not used to treat mania. If you are pregnant and taking Lamotrigine, NICE recommends you are checked regularly.
(See our pages on mood stabilisers for more information about these drugs.)
In some circumstances you might also be offered antidepressant medication, such as selective serotonin reuptake inhibitors (SSRIs) – a commonly prescribed type of antidepressant. You might be offered antidepressants in combination with one of the medications described above.
Remember: You should always check with your doctor or pharmacist before taking any drugs together, or closely following one another, in case they could interact with each other badly. For example, combining lithium with SSRI antidepressants can increase the risk of serotonin syndrome (a serious side effect).
(See our pages on antidepressants for more information about these drugs, including potential side effects.)
This information was published in May 2018. We will revise it in 2021.
References are available on request. If you would like to reproduce any of this information, see our page on permissions and licensing.