Bipolar Disorder Treatment

Bipolar Disorder Treatment

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  • 1 Answer
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    ARuth White, MPH, Social Work, answered
    Some questions you may want to ask your doctor when discussing bipolar medication with your mental health provider are as follows:

    1. Why am I taking this medication rather than any of the other medications that could be prescribed for this condition?
    2. What are some of the side effects I will likely experience, and is there anything I can do to alleviate or prevent some of them from occurring?
    3. Are there any possible interactions among the medications that I'm already taking? Is there any way to alleviate or prevent these interactions? Would substituting another medication alleviate or eliminate these interactions?
    4. Are there any nutritional supplements, dietary considerations, or behavioral changes that could reduce my dependence on a particular medication?
    5. Are there any foods or activities I should avoid while taking these medications?
    6. Please give me complete medical information on all the medications you're prescribing for me (if this was not already done or you no longer have that information).
  • 1 Answer
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    ARuth White, MPH, Social Work, answered
    Once you know and consistently take the prescribed medications for bipolar disorder, you may want to have some discussions with your medical provider about the effectiveness and side effects. Some side effects are more problematic for some people than for others; for example, whereas one person may be okay with weight gain, others may find it intolerable.

    On a regular basis (annually or every six months), talk to your healthcare provider about the drugs you're taking. At these intervals, discuss side effects, effectiveness of symptom reduction, or any changes in your behaviors. Also ask about any new scientific information on the effectiveness of the drug or any new side effects or risks that have been discovered. You may want to try new drugs that have come onto the market to see if they work better for you. However, you may want to stick with the medication that works for you rather than risk episodes or new side effects by trying something new.
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    ARuth White, MPH, Social Work, answered
    The goal of this exercise is to educate you (and inform your mental healthcare provider) about all the medications you're taking, whether for bipolar disorder or other conditions. For each drug you're taking, you'll record some detailed information. You can use a table format or simply have a paragraph for each drug. Here's the information you'll record:

    1. What's the chemical (generic) name of the medication?
    2. What's the brand name (if applicable; that is, if it's not a generic drug) of the medication?
    3. How much of the medication are you taking? (For example, the number of pills you take each time you take the medication and the amount of medication in each pill)
    4. How often do you take the medication? (For example, twice a day or every four hours and so on)
    5. What's the health problem for which this medication was prescribed?
    6. How long you have been taking this medication?
    7. What side effects do you think you may be experiencing as a result of taking this medication?

    Bring your answers to your prescribing provider so that possible interactions can be avoided and prescribing can be based on as much information as possible. Be honest in reporting your compliance with medications, because if it's prescribed but you aren't taking it, this must be taken into account when new prescriptions are made or when your medical provider tries to understand the nature of your symptoms. If you've taken other drugs previously for the same condition, it would be useful to list the names of the drugs you took prior to the current one and why you stopped taking them. Finally, also answer these questions for any alternative medications or nutritional supplements you're taking. All this information helps develop the medication regimen that works best for you.
  • 1 Answer
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    ARuth White, MPH, Social Work, answered
    To take your bipolar medications as prescribed and trust that they'll work, you must know the medications you're taking and their possible side effects so you can distinguish medication side effects from other medical problems you may have and from symptoms of the illness itself.

    In addition to asking your healthcare provider, you can do your own research on your medications. One good source of information is the online version of the Physicians' Desktop Reference (PDR) (also found in print at your local library). The PDR is based on information provided by the U.S. Food and Drug Administration (FDA). Simply typing in the name of your medication will get you other names, side effects, actions, indications, how the medicine is supplied, special warnings, and possible food and drug interactions. It's easier to search by brand name than the generic name of the medication. There's also a picture of the medication. For example, when searching for lithium, the PDR shows Eskalith (one of the trade names for this chemical) and lets us know that it's available in pill and capsule form.

    Another resource is the Consumer's Guide to Psychiatric Drugs (Preston, O'Neal, and Talaga 2009), or A Concise Guide to Medical Treatment for Bipolar Disorder in Adults and Adolescents (a Kindle eBook), which describes medical treatments for bipolar disorder in detail.
  • 2 Answers
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    ARuth White, MPH, Social Work, answered
    The key factors that contribute to your bipolar medication compliance are patience and hope that the medications will work. If you have hope, you'll be motivated to stick with your medication despite side effects, and you also need patience to be willing to make adjustments until you find the medication that's right for you. Medications take time to work, and you may have to try several different drugs before you find one or more that work for you. To keep on the treatment path, stay hopeful that you'll find the right combination of medications that work for you. Use your time in psychotherapy or your support group to learn maintenance strategies and find support for compliance with your medication regimen.
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  • 1 Answer
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    ARuth White, MPH, Social Work, answered
    Any changes in bipolar medication should be done in consultation with your healthcare provider. Trying it on your own will likely lead to a bipolar episode and all the life-disrupting outcomes that ensue. The good feelings that often are a part of the experience of mania or hypomania lead some people to stop taking their medications, which triggers or exacerbates an episode and may lead to increased severity of symptoms. The goal of treatment is to stay healthy and get off that emotional and psychological roller-coaster ride.
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    ARuth White, MPH, Social Work, answered
    Some people with bipolar disorder find that the number of pills they have to take and the importance of taking certain pills at certain times of day can be frustrating. It's easy to forget to take a dose, which may begin to trigger manic or depressive episodes. Daytime drowsiness is a major problem with many mood stabilizers and often interferes with compliance because it gets in the way of daily responsibilities, such as work, chores, child care, and so forth.

    If you find that you have trouble remembering to take your prescribed doses at certain times of day or that certain medications have negative effects at certain times of day (for example, you feel drowsy in the morning after taking lithium), speak to your provider about rearranging your medication schedule to better fit your lifestyle. You may be able to take different dosages at different times of day, change your medications to alleviate daytime drowsiness, or change medications altogether.
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    ARuth White, MPH, Social Work, answered
    Many psychotropic medications for bipolar disorder, such as lithium, Depakote (divalproex), and Zyprexa (olanzapine), may cause liver and/or kidney damage. Your prescribing provider should schedule quarterly (at minimum) blood tests to monitor your liver and kidney functions. He or she will discuss these results with you and make any adjustments to your medication regimen as needed.
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    ARuth White, MPH, Social Work, answered
    Most bipolar medications can cause sedation and daytime fatigue. Often these side effects are seen to occur during the first few days or weeks after starting the medication. This side effect can be problematic, but can also be helpful, if the sedation occurs at night (and thus can help a person fall asleep). However, if the sedation lasts into the day, this may interfere with feeling alert (impacting one's ability to work or go to school). It is very rare that the sedation can interfere with the ability to drive safely.
  • 1 Answer
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    ARuth White, MPH, Social Work, answered
    Nausea is often caused by taking bipolar medication on a full or empty stomach, so make sure you follow the directions exactly as written. If you experience nausea, you may find that eating water crackers or saltine crackers relieves symptoms. You may also want to take your medications with peppermint or ginger tea, or ginger ale, all of which are known to relieve nausea.