Treatment with Medication

Medication for bipolar disorder can often control symptoms. Sometimes a person may need to try several different options before the right medication is found. It’s important to remember that every person is different, and what works well for one might not be best for another.

There are several types of medications that are used to treat bipolar disorder. A doctor will prescribe the medication that he or she determines will best manage the illness based on the current science and research literature available.

Determining the right medication or medication combination takes time and patience. Working closely with the doctor can help determine the best medication for each person.

Bipolar disorder is treated mainly with 3 types of medication:

Mood-stabilizing medications
Mood stabilizers are medications used to treat bipolar disorder and can be taken for many years. Except for lithium, mood-stabilizing medications are anticonvulsants, which are usually used to control seizures but also help the symptoms of mania and help control moods.

Antidepressant medications
Antidepressants can be used in the treatment of bipolar-related depression.

Atypical antipsychotic medications
Atypical antipsychotic medications are also used to treat the symptoms of bipolar disorder, sometimes in conjunction with other medications.

How are antipsychotics used to treat bipolar disorder?

Antipsychotics can be taken by mouth (oral medication) or by injection (short-acting medication or long-acting medication).

Oral medicines come in tablet, capsule, and liquid forms. They may need to be taken multiple times a day.

Injectables can be either short-acting or long-acting medicines.

Types of Injectable Medications

There are two kinds of injectable antipsychotic medications—short-acting and long-acting. Both types are administered to an individual by a trained healthcare professional. These medicines can be given by intramuscular injection. In most cases, the patient only needs to expose a small area of skin without having to take off any clothing.

Short-Acting Injectable Medications work fast and are used by doctors when they need the medication to start working very quickly — like during a crisis episode or hospitalization.

Long-Acting Injectable Medications are mainly used in maintenance therapy and do not need to be taken every day. They are taken every few weeks.

When taking a long-acting injectable medication, the antipsychotic medicine is released slowly and steadily in the body over the course of a few weeks. As a result, the medication does not need to be taken every day — only once every few weeks.

Long-acting antipsychotic injectable medicines—in addition to helping many people manage symptoms—may offer some additional benefits for individuals and their caregivers. For example:

  • They may provide opportunities to talk with the treatment team due to regular injection appointments
  • They enable the treatment team to know if patients are on track with their medication and the doctor to inform patients and their caregivers (if the patient consents) of any time a dose is missed
  • There is one fewer medication for the caregiver to remind the patient to take every day

Nonpharmacological treatments for bipolar disorder include:

Psychotherapy [to learn more, visit the >Additional Supportive Treatment section], and,

Electroconvulsive therapy (ECT)
Today, ECT is used to treat some people with bipolar disorder for whom medication and/or talk therapy have not worked well. Previously known as “shock therapy,” ECT once was viewed negatively and feared by some people. Recently, the practice of ECT has improved and may help some people whose condition has not improved with other treatments. If your doctor recommends ECT, a trusted member of the recovery team that you identify can support you throughout the process. It may be comforting to know that this person may be able to even accompany you to the actual treatment and stay by your side.

Read the next section: Choosing the Right Medication