Medications to Treat Bipolar Disorder – Medications to Treat Bipolar Disorder.People with bipolar disorder need ongoing care. In fact, even if you feel better, you should see a mental health professional regularly. Treatment usually includes a combination of medication and talk therapy.

Medications to Treat Bipolar Disorder

Psychiatrists usually recommend drugs as the first treatment to get symptoms under control as soon as possible. Once your symptoms are under control, you will receive maintenance treatment to reduce the risk of a recurrence. Maintenance treatment also reduces the risk of mild mood swings developing into mania or depression. Several types of medications are used to treat bipolar disorder. These include mood stabilizers, antidepressants, and anxiety-relieving medications. Your doctor may prescribe more than one drug to get the most benefit.

Finding the right drug or drug combination takes trial and error. You may need to change medications because of side effects.

It may take up to eight weeks to see the full effect of either drug. Usually only one drug can be changed at a time. This helps doctors better monitor and identify those that aren’t working. The following types of medications are used to treat bipolar disorder:


Lithium (as Lithobid) is a mood stabilizer that has been used since the 1970s. It helps control the symptoms of acute mania. It is also effective in preventing relapse of mania and depression.

Common side effects include weight gain and digestive problems. This medicine can also affect the thyroid and kidneys. Regular blood tests are needed to monitor thyroid and kidney health. Lithium is a category D drug, if possible during pregnancy. However, in some cases, the benefits outweigh the potential risks.


Anticonvulsants are mood stabilizers used to treat bipolar disorder. They have been used since the mid-1990s. Anticonvulsant drugs include:

  • divalproex sodium (Depakote)
  • lamotrigine (Lamictal)
  • valproic acid (Depakene)

Common side effects of anticonvulsants include weight gain, drowsiness, and difficulty sitting still. Anticonvulsants are also associated with an increased risk of suicidal thoughts and actions. Valproate is known to cause birth defects. Lamictal can cause dangerous rashes. If you get a new rash while taking Lamictal, talk to your doctor.


Antipsychotic drugs are another treatment option. Some commonly prescribed antipsychotics include:

  • olanzapine (Zyprexa)
  • risperidone (Risperdal)
  • quetiapine (Seroquel)
  • lurasidone (Latuda)
  • aripiprazole (Abilify)
  • asenapine (Saphris)

Common side effects include weight gain, drowsiness, dry mouth, decreased sex drive, and blurred vision. Antipsychotic drugs can also affect memory and attention. It is also known to cause involuntary movements of the face and body.


These include selective serotonin reuptake inhibitors (SSRIs), selective serotonin reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MAOIs), and tricyclic antidepressants.

Antidepressants can be added to help manage depression in bipolar disorder, but they can sometimes trigger manic episodes. It is often prescribed along with mood stabilizers or antipsychotics to reduce the risk of mixed or manic episodes.

As with any medication, you should talk to your doctor about the risks and benefits of taking antidepressants for bipolar disorder. Here are some of the most commonly prescribed antidepressants:


  • desvenlafaxine (Pristiq)
  • duloxetine (Cymbalta, Yentreve)
  • venlafaxine (Effexor)


  • citalopram (Celexa)
  • escitalopram (Lexapro)
  • fluoxetine (Prozac, Prozac Weekly)
  • paroxetine (Paxil, Paxil CR, Pexeva)
  • sertraline (Zoloft)


  • amitriptyline
  • desipramine (Norpramin)
  • imipramine (Tofranil, Tofranil-PM)
  • nortriptyline (Pamelor)


  • phenelzine (Nardil)
  • tranylcypromine (Parnate)

In general, MAOIs are rarely prescribed unless the patient responds poorly to SNRIs or SSRIs. Common side effects include decreased libido, sleep disturbances, increased appetite, dry mouth, digestive problems, and painful menstruation. When taking an MAOI, it’s important to avoid alcohol, other drugs, and foods like cheese that can cause a rare but serious condition called serotonin syndrome.


These are a group of medications with anxiety-relieving properties. Benzodiazepines include:

  • alprazolam (Xanax)
  • chlordiazepoxide (Librium)
  • clonazepam (Klonopin)
  • diazepam (Valium)
  • lorazepam (Ativan)

Side effects can include drowsiness, poor muscle coordination, and problems with balance and memory. These medications should be used with caution due to the risk of addiction.


This drug is a combination of fluoxetine and the antipsychotic olanzapine. Symbyax has antidepressant and mood stabilizing properties. Side effects may include increased appetite, sexual problems, drowsiness, fatigue and dry mouth.

If your doctor has prescribed this medicine for you, ask if separate prescriptions for the two components are cheaper. There is nothing different from a mixed pill. It is simply a new formulation of two existing drugs.

Medications and pregnancy

Some drugs, such as lithium and valproic acid, can increase the risk of birth defects in the fetus. Some medicines can make birth control pills less effective. Always consult your doctor if you are using birth control to prevent pregnancy.

Also, if you are breastfeeding, you should discuss your medications with your doctor. Some medicines may not be safe for your baby.