Lithium is used for the long-term treatment of mania. It can reduce how often you get an episode and how severe they are. It has been found to reduce the risk of suicide. NICE guidance for bipolar disorder recommends lithium as a first choice, long-term treatment to treat episodes of mania.
Lithium is the oldest and most well-known mood stabilizer and is highly effective for treating mania. Lithium can also help bipolar depression.
Lithium. Lithium (Eskalith, Lithobid) is the drug used and studied longest for treating bipolar disorder. It helps make mania less severe and more rare. And it may also help relieve or prevent bipolar depression in some people.
Mood stabilizers work by decreasing abnormal activity in the brain. These medications can help reduce mood swings and prevent manic and depressive episodes.
Lithium (lithium carbonate or lithium citrate)
Lithium is used to treat mania and to prevent further episodes of mania and depression.
Medications are typically needed to stop manic episodes. These can Include mood stabilizers like lithium, depakote, and lamotrigine, or antipsychotics like risperidone, aripiprazole and olanzapine. Antidepressants are not used in treating acute mania, as they typically worsen the condition.
Lamotrigine has shown no efficacy in treating acute mania, which makes it less desirable than lithium, quetiapine, or cariprazine in that there will be no coverage for the manic/hypomanic phases.
Its greatest benefit is in prevention. It can prevent both the depressive and manic side, but its benefits are much stronger for depression and it does not treat active mania or hypomania." Dr. Aiken adds that part of the reason patients prefer lamotrigine is that it's generally well tolerated.
Take medicines as instructed by your doctor to help reduce the number of manic episodes. To help prevent a manic episode, avoid triggers such as caffeine, alcohol or drug use, and stress. Exercise, eat a balanced diet, get a good night's sleep, and keep a consistent schedule.
Lithium, divalproex and several atypical antipsychotics (olanzapine, risperidone, quetiapine) are first-line antimanic agents.
In terms of pharmacological management, first line agent for management of mania may involve use of lithium or valproate, olanzapine, haloperidol, quetiapine, aripiprazole, risperidone, paliperidone or ziprasidone as monotherapy.
In general, the anti-suicidal effect of lithium, even unrelated to bipolar illness, has most consistent data and shows that lithium is superior to valproate [6,36,93,94,100].
In December 2021, the FDA approved Caplyta for bipolar depression. It can be used by itself or in combination with lithium or valproate. Caplyta is a once-daily oral pill that needs no dose changes. Caplyta has some serious risks, but they're rare.
Caplyta is now FDA-approved for depressive episodes from bipolar I and II. The US Food and Drug Administration (FDA) has approved Caplyta (lumateperone) for the treatment of bipolar depression in adults.
You'll typically need mood-stabilizing medication to control manic or hypomanic episodes. Examples of mood stabilizers include lithium (Lithobid), valproic acid (Depakene), divalproex sodium (Depakote), carbamazepine (Tegretol, Equetro, others) and lamotrigine (Lamictal).
Lamotrigine used as an adjuvant mood stabilizer has been reported to induce mania1 and hypomania2 in case reports.
It can prevent both the depressive and manic side, but its benefits are much stronger for depression and it does not treat active mania or hypomania." Dr. Aiken adds that part of the reason patients prefer lamotrigine is that it's generally well tolerated.
Lamotrigine (Lamictal) can cause serious skin reactions like rash. Lithium is used to treat bipolar disorder and manic episodes. It has a lot of unwanted side effects and requires frequent monitoring of lithium levels in the blood so it might not be a convenient option for some people.
You may require hospitalization if you have severe hallucinations or delusions, or to prevent you from harming yourself or others. It's important to have a good understanding of mania, mania symptoms, your particular triggers and ways to better manage your manic episodes.
Research has shown that the most common trigger for episodes of mania is sleep loss. This can be in the form of sleep disturbances, disruption, jet lag, and an inconsistent sleep schedule. Sleep disturbances rarely cause episodes of hypomania, but it does happen—particularly in individuals with bipolar I.
There are three stages of mania: hypomania, acute mania and delirious mania. Classifications of mania are mixed states, hypomania and associated disorders. Mania can occur in cycles over several weeks or months with no predictable triggers.