Definition
Bipolar disorder is a psychiatric disorder characterized by an alternation of depressive states and manic or hypomanic states.
Basically, there are three different types of bipolar disorder:
- Bipolar type I disorder (characterized by manic-depressive episodes);
- Bipolar type II disorder (characterized by hypomanic-depressive episodes);
- Cyclothymic disorder or cyclothymia (a disorder whose minimum duration is two years and which is characterized by hypomanic-depressive episodes).
Causes
The causes of the onset of bipolar disorder are still unknown. However, it is believed that factors such as genetic predisposition, psycho-social conditions, very stressful or traumatic events and a dysregulation in the levels of neurotransmitters such as serotonin and noradrenaline, are involved in the etiology of the disease.
Symptoms
As mentioned, bipolar disorder is characterized by the alternation of depressive stages and manic states. Therefore, the symptoms that can occur are manifold. These include hallucinations, aggression, delusions, euphoria, increased or decreased appetite, difficulty concentrating, depression, suicidal behavior, nightmares, insomnia, social isolation, weight loss, nervousness, anxiety and anhedonia.
Information on Bipolar Disorder - Drugs for Treating Bipolar Disorder is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Bipolar Disorder - Bipolar Disorder Medication.
drugs
The most commonly used drugs for the treatment of bipolar disorder are mood stabilizers.
Alternatively, other drugs can also be used, such as some types of antiepileptics, antipsychotics and antidepressants.
Furthermore, psychotherapy could also be useful in treating this condition.
However, one cannot speak of a real definitive cure for bipolar disorder, since this disease tends to recur over time.
Lithium carbonate
Lithium carbonate (Carbolithium ®) is a mood stabilizer and is the drug of first choice for the treatment of bipolar disorder, since it is able to act both on the depressive component and on the manic component. The dose of medication usually used in adults and adolescents is 300 mg, to be taken orally 2-6 times a day.
Treatment with lithium carbonate can also be accompanied by treatments with other drugs, such as antiepileptics, antipsychotics and antidepressants.
antiepileptic
Some antiepileptic drugs have proven to be very effective in treating bipolar disorder, as well as for treating epilepsy. These drugs are:
- Lamotrigine (Lamictal ®): Lamotrigine is particularly effective in treating the depressive phases of bipolar disorder. Furthermore, it also appears to be able to prevent the recurrence of further depressive episodes. Usually, lamotrigine is administered orally at a dose of 100-400 mg per day.
- Valproate (Depakin ®): valproate has been shown to be effective in treating the manic phase of bipolar disorder and is used when lithium carbonate is not tolerated or contraindicated. The initial dose of valproate usually used is 750 mg a day, to be administered orally. Later, the doctor will adapt the dose of the drug based on the patient's response to therapy.
- Carbamazepine (Tegretol ®): carbamazepine - such as valproate - has also been shown to be effective in treating manic episodes in individuals with bipolar disorder. The dose of medication usually used is 400-600 mg, to be taken orally 2-3 times a day.
Antipsychotics
Antipsychotic drugs are used in the treatment of the manic phase of bipolar disorder. They can be used alone, in combination with valproate or in combination with antidepressants.
Among the antipsychotics most used in the treatment of bipolar disorder, we recall:
- Aripiprazole (Abilify ®): aripiprazole is mainly used for the treatment of the manic episodes of bipolar I type disorder. The dose of the drug usually used in adults is 15 mg a day, to be taken orally.
- Asenapine (Sycrest ®): the dose of asenapine usually administered orally is 5-10 mg twice a day.
- Olanzapine (Zyprexa ®, Olanzapine Teva ®, Olanzapine Mylan ®, Zyprexa Velotab ®, Zalasta ®, Olanzapine Neopharma ®): the dose of olanzapine usually used in the treatment of bipolar disorder is 10-15 mg a day, to be taken orally .
- Quetiapine (Seroquel ®): the dose of quetiapine usually administered ranges from 150 mg to 800 mg.
Antidepressants
Antidepressant drugs, in truth, are not a first choice treatment for bipolar disorder. Furthermore, they should never be administered alone, but always in combination with antipsychotic or lithium carbonate drugs. In fact, the exclusive administration of antidepressant drugs in patients suffering from bipolar disorder can cause a worsening of the symptoms of the disease.
The antidepressants that can be used are selective serotonin reuptake inhibitors (or SSRIs), tricyclic antidepressants, IMAO-A (type A monoamine oxidase inhibitors) or atypical antidepressants, such as bupropion.
When antidepressants are used to treat bipolar disorder, the dose of drug to be administered must be established by the doctor on a strictly individual basis, depending on the patient's condition, the type of antidepressant used and the type of combination therapy chosen (with antipsychotics, with lithium or with both).
