For roughly one-third of people diagnosed with bipolar disorder, lithium is a miracle drug, effectively treating both their mania and depression. But once someone is diagnosed, it can take up to a year to learn whether that person will be among the 30 percent who respond to lithium or the 70 percent who do not.
Lithium: The first mood stabilizer for bipolar disorder. Mood stabilizers are medications that help control the highs and lows of bipolar disorder. They are the cornerstone of treatment, both for mania and depression. Lithium is the oldest and most well-known mood stabilizer and is highly effective for treating mania.
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.
Antipsychotics for bipolar disorder
The National Institute for Health and Care Excellence (NICE) – the organisation that produces guidelines on best practice in healthcare – recommends the following antipsychotics: haloperidol – also known as Dozic, Haldol, Haldol Decanoate, Serenace.
Lumateperone (Caplyta) and Quetiapine (Seroquel, Seroquel XR) is used for the short-term treatment of bipolar depression. Another option is olanzapine (Zyprexa) with fluoxetine (Prozac). The atypical antipsychotic lurasidone (Latuda) can be taken alone or with lithium or valproate for treating bipolar depression.
The U.S. Food and Drug Administration (FDA) approved Rykindo as an extended-release injectable version of risperidone on January 15, 2023, according to a press release from Luye Pharma, the company that developed the drug.
Sublingual dexmedetomidine (Igalmi) was approved last year for acute agitation in adult patients with schizophrenia or bipolar I or II disorder. Keep a look out for these medications, as xanomeline-trospium will be coming in 2023 and lumateperone, Rykindo, and Igalmi have been FDA-approved within the past year.
Symptoms of depressive episodes include low energy and motivation, lack of interest in daily activities and sometimes suicidal thoughts. Bipolar disorder is a chronic disease, and while there is no cure, there are medicines and other therapies that can help people function well and lead fulfilling lives.
Bipolar I disorder is the most severe form of the illness. Bipolar II disorder is characterized by predominantly depressive episodes accompanied by occasional hypomanic episodes. Hypomanic episodes are milder than manic episodes but can still impair functioning.
CAPLYTA is a once-daily pill proven to deliver significant symptom relief from bipolar I and bipolar II depression. CAPLYTA can be taken alone or with lithium or valproate.
Some individuals with bipolar see a link between their diagnosis and their high achievement—sometimes as a result of hypomania's enhanced energy and creativity levels and sometimes because of the degree of focus and self-management required to address symptoms and prevent or cope with mood swings.
People with bipolar disorder can live a good life, be happy and be successful—just like anybody else.
According to Steve Guglielmi, a licensed professional clinical counselor-supervisor at LifeStance Health, bipolar disorder can change with age. Guglielmi explained that, similar to most mental and physical health-related concerns, bipolar symptoms can increase in severity and frequency if left untreated.
Currently, there are only 3 drug treatments approved for the acute bipolar depression: olanzapine/fluoxetine combination (OFC), quetiapine (immediate or extended release), and lurasidone (monotherapy or adjunctive to lithium or valproate).
Last December, the U.S. Food and Drug Administration (FDA) approved an expanded indication for the antipsychotic Caplyta (lumateperone) for the treatment of bipolar I and II depression in adults. Caplyta, marketed by Intra-Cellular Therapies Inc., was already approved for the treatment of schizophrenia in adults.
Lithium is a long-term treatment for episodes of mania and depression. It's usually prescribed for at least 6 months. If you're prescribed lithium, stick to the prescribed dose and do not stop taking it suddenly unless told to by your doctor. For lithium to be effective, the dosage must be correct.
Lithium (Eskalith, Lithobid): This simple metal in pill form is highly effective at controlling mood swings (particularly highs) in bipolar disorder. Lithium has been used for more than 60 years to treat bipolar disorder.
Marijuana
Marijuana is one of the most widely used drugs in the world. It contains the compound THC, which produces a euphoric high when smoked or ingested. Many people use marijuana to relax, reduce anxiety, and enhance their creativity.