Bipolar Disorder Treatment Medications What Medications Are Used to Treat Bipolar Disorder? By Theodora Blanchfield, AMFT Theodora Blanchfield, AMFT Twitter Theodora Blanchfield is an Associate Marriage and Family Therapist and mental health writer. Learn about our editorial process Published on June 23, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Staticnak1983 / Getty Images Table of Contents View All Table of Contents Bipolar Disorder Treatment Medication Treatment Antidepressant Medications In most cases of bipolar disorder, medication is used to help keep someone stable. Medications that are prescribed may be used to treat psychosis, depression, hypomania, or mania present in someone who has bipolar disorder. While once lithium was the only medication used for bipolar disorder, there are now many medications used in the management of the illness that fall under the following categories: anticonvulsants, antidepressants, antipsychotics, and benzodiazepines. This article covers some of the most common medications used to treat bipolar disorder as well as some other non-pharmacological treatments. Bipolar Disorder Treatment Typically, treatment for bipolar disorder includes medication in addition to psychotherapy. Sometimes more than one medication may be recommended in order to manage symptoms. In fact, one study showed that about half of patients with bipolar disorder take at least three psychotropic medications. For example, a benzodiazepine may be added to a mood stabilizer to treat symptoms of anxiety or sleep disturbances that may occur in bipolar disorder. Psychotherapy to Treat Bipolar Disorder Psychotherapy is often used in conjunction with medication to help people with bipolar disorder manage their condition long-term and prevent new episodes. Some modalities that are commonly used in people with bipolar disorder include: Psychoeducation (individual or group) Cognitive-behavioral therapy Family-focused therapy Interpersonal and social rhythm therapy Group mindfulness-based cognitive therapy Integrated group therapy Dialectical behavioral therapy Other treatments may include dark therapy, electroconvulsive therapy, transcranial magnetic stimulation and ketamine. What Is Therapy for Bipolar Disorder? Medications Used to Treat Bipolar Disorder Bipolar disorder treatment may include lithium, one of the mainstays of bipolar disorder treatment, anticonvulsants, antidepressants, antipsychotics, or benzodiazepines. Here's what you need to know about each of these types of medications. Lithium Although lithium is a mineral that is found naturally, it was not until 1949 that lithium was discovered, by John Cade, to be helpful in treating manic episodes. However, lithium was not approved by the US FDA until 1970 as a medication to treat bipolar disorder. Lithium is thought to act as a mood stabilizer,which reduces mood swings. It may also help with decreasing suicide risk. It has been studied to be particularly helpful in elderly people dealing with mania. It may even be helpful in treating unipolar depression (depression without mania). Anticonvulsant Medications for Bipolar Disorder Though the reason that these medications are effective in bipolar disorder is not completely clear, one theory is that anticonvulsant medications make nerve cells in the brain less excitable, thus leading to a lower likelihood of mania or depression. One theory is that they raise the levels of the neurotransmitter GABA,which calms the brain. They may also modulate glutamate. This neurotransmitter is an excitatory one, meaning it causes other neurons to fire; elevated levels of glutamate are often found when someone is experiencing mania. However, not all anticonvulsants help the same symptoms. For example, Depakote (Divalproex sodium) and Tegretol (carbamazepine) tend to work particularly well on mania; Lamictal (lamotrigine) is particularly successful in targeting depression. Other common anticonvulsants sometimes used for bipolar disorder include: GabapentinTopiramateTiagabineOxcarbazepine Anticonvulsants for Mania in Bipolar Disorder Antidepressant Medications for Bipolar Disorder Prescribing antidepressants for bipolar disorder can be controversial; some believe they are helpful while others believe that they may actually make it worse, triggering mania and increasing mood cycling. However, something many in the field do agree on is that antidepressants should not be used as mono therapy (the only treatment someone is on) for bipolar disorder. And some antidepressant classes such as tricylics or serotonin-norepinephrine reuptake inhibitors (SNRIs) may cause a higher “switch” rate (from depression to mania), than selective serotonin reuptake inhibitors (SSRIs) and bupropion. SSRIs include: Celexa (citalopram) Lexapro (excitalopram) Prozac (fluoxetine) Luvox (fluvoxamine) Paxil (paroxetine) Zoloft (sertraline) Viibryd (vilazodone) Trintellix (vortioxetine) Antipsychotic Medications for Bipolar Disorder Antipsychotic medications are often prescribed for those with bipolar disorder—especially with Bipolar 1, where delusions and hallucinations are present. Antipsychotic medications can help manage psychotic symptoms associated with bipolar illness and the newer "atypical" antipsychotics have mood-stabilizing properties. These types of medicines come in two classes: newer ones called “atypical” antipsychotics, and older ones referred to as “typical” antipsychotics. Generally, the atypical antipsychotics have a different side effect profile than the older antipsychotics. Combining Antipsychotics With Mood Stabilizers Frequently, an antipsychotic will be prescribed with a mood stabilizer, and research shows that the combination of the two can be more effective than just one alone. However, the older antipsychotics are often associated with extrapyramidal symptoms, otherwise known as movement-related side effects, such as acute dystonic reactions, parkinsonism, akinesia, and akathisia. They also carry a somewhat greater risk of tardive dyskinesia and neuroleptic malignant syndrome. However, the atypical antipsychotics aren’t perfect either; these agents may carry a higher risk of metabolic side effects such as weight gain and type 2 diabetes. Seroquel (quetiapine), Latuda (lurasidone), and Vraylar (cariprazine) are the atypical antipsychotics that have an indication for depression in bipolar disorder. Zyprexa (olanzapine) and Clozaril (clozapine) also show high levels of efficacy in treating different aspects of bipolar disorder. Benzodiazepines for Bipolar Disorder Benzodiazepines, anti-anxiety medications, are sometimes prescribed for people with bipolar disorder to treat agitation, anxiety, and sleep disturbances associated with acute mania or bipolar depression. There is some risk of dependence and abuse with these medications, so they tend to be used for the short-term management of the disorder. A Word From Verywell Many of these medications have side effects if you stop taking them abruptly, so talk to your doctor before making any changes to your medication routine. 18 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Weinstock LM, Gaudiano BA, Epstein-Lubow G, Tezanos K, Celis-deHoyos CE, Miller IW. Medication burden in bipolar disorder: A chart review of patients at psychiatric hospital admission. 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Psychiatric Clinics of North America. 2005;28(2):325-347. doi:10.1016/j.psc.2005.01.001 By Theodora Blanchfield, AMFT Theodora Blanchfield is an Associate Marriage and Family Therapist and mental health writer. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist Online Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.