Home

Feature Article:

Your Body’s Secret Wisdom-- Eating from the Tree of Life
Your body’s secret wisdom is as ancient as humankind and encoded in every cell. It knows the perfect food for you to eat at any point in time. Yet we have lost touch with that perfect knowledge in this industrial society. We have lost touch with our...
...Read More


What is the Treatment for Bipolar Disorder?

Additional Reading


How do we treat bipolar disorder? Specifically, how do we treat mania or depression associated with bipolar disorder? The treatment of these two clinical states is not the same.

The treatment of mania is dependent upon its severity and acuity. For mild to moderate mania, mood stabilizers such as lithium and valproic acid (Valproate) are still the standard of treatment and may be sufficient to contain the symptoms. Lithium starts to work after 10 to 14 days while valproic acid, about 7 to 10 days.

Also, recent studies have shown the effectiveness of atypical antipsychotics such as risperidone, olanzapine, and quetiapine even when used alone to treat the acute phase of bipolar disorder.

These drugs are relatively safe but they don’t come without side effects. Nausea, vomiting, tremors, and dizziness during the initial phase of treatment are commonly experienced. The more serious side effects such as renal and thyroid problem from lithium, liver dysfunction and pancreatitis from valproic acid, and increased risk of diabetes and high cholesterol from atypical antipsychotics are uncommon. However, regular blood tests are required to monitor any abnormalities.

For moderate to severe cases, atypical antipsychotics such as risperidone and quetiapine should be added to the mood stabilizers during the acute phase. Once the illness has stabilized and the symptoms have subsided, then the atypical neuroleptics can be gradually tapered off. But the mood stabilizers should continue. Regardless of severity, patients usually do well on a combination of mood stabilizer and atypical antipsychotic during the acute phase.

What is the treatment for bipolar depression? In general, the mood stabilizers’ dosage should be optimized or if the patient is not on any medication yet, a mood stabilizer such as lithium should be started. Physicians should make sure that the medication maintains a “therapeutic level.” If not, the dosage should be adjusted. Moreover, possible precipitants such as stresses at home should be addressed.

If these measures don’t help and the depression is so severe, an antidepressant with the least risk to induce mania such as bupropion should be added to the mood stabilizer. When the depression is resolved, then the antidepressant can be gradually tapered off because its prolonged use even in the presence of mood stabilizer can still induce mania.

When should the medication be discontinued? Bipolar patients have to continue taking the medication for several months even after they become normal. High relapse rate is common if medications are prematurely stopped. Also, for patients with multiple or difficult-to-treat episodes, they may need to take the medication for years or even for life to prevent recurrence.

Patients and their physicians should thoroughly discuss the risk and benefits of any treatment intervention. Knowledge about the drug’s indication, side effects, and prognosis with or without treatment is a must.

Furthermore, it is crucial that bipolar patients should also receive individual psychotherapy to help them deal with the many personal and psychosocial issues they face on a daily basis. As you know, medication alone won’t suffice to address financial problems, marital conflict, work issues, and prior abuse.

In summary, the combination of medication and psychotherapy is the best treatment for bipolar disorder.

Copyright © 2004. Dr. Michael G. Rayel – author (First Aid to Mental Illness–Finalist, Reader’s Preference Choice Award 2002) psychiatrist, and inventor of Oikos Game: A Personal Development and Emotional Skills Game. For more information, please visit http://www.oikosgame.com.

 

More Reading:


The Cold Facts about Hypothermia

Sunburn Skin Cancer and Aging of the Skin

Your Bodys Secret Wisdom Eating from the Tree of Life

Basic White Contact Lenses

No One Ever Got Fat Eating Broccoli

 
Proven Strategies to Effectively Burn Fat Out Of Your Body Part 1

Wholesale Massage Chairs Direct from Premier

EXERCISE and LOW CARB DIETS

NotOneOunce Junk at the Office

Practical Ways to Keep Your ADD Under Control During the Holiday Season


Graphology for Sex / Graphology and Sex
First of all Thanks for coming this to page. Our sexual drive has effect on our personality & impacts our personal- social -professional- Social Success & development ratio. Before marriage or before experimenting the sex every person thinks...
...Read More

A Proven Way That Women Can Quit Drinking Without AA
A Proven Way That Women Can Quit Drinking Without AA Alcoholics Anonymous (AA) has helped millions of people recover from alcoholism. For many women, however, AA may not be the best choice when it comes to the difficult task of quitting...
...Read More

Christopher Reeve To Have Promoted Basement Lab
Chrisopher Reeve has died. But his vision of a “Cure” has not. Mr. Reeve, who became a quadripilegic after a horse riding accident in 1995, was best known as advocate for stem cell research which promises cures for spinal cord injuries. Shortly...
...Read More

Snack Ideas for Kids That Won't Wreck Mom's Diet
If you are a mom at home on a diet, you will probably related to a frequent situation I encounter as a weight loss consultant. Many of my clients with children are able to keep to a healthy eating plan through most circumstances except two. It...
...Read More

Are You In The Grip Of Candida?
Are You In The Grip Of Candida? If you have an ongoing immune problem, it is very possible that you have an overgrowth of Candida. Candida is a symbiotic yeast, which lives in us and on us, as part of our normal collection of...
...Read More