Bipolar depression used to be treated with sedatives and drugs which had a lot of side effects. Currently, the chief support treatment for bipolar disorder includes mood-stabilizers. Physicians might prescribe an anti-manic drug such as lithium or an antipsychotic drug or a combination of the two so as to relieve bipolar depression symptoms without provoking a manic episode. Given that manias are less common than depression episodes which have a greater effect on patients’ lives, established treatments for bipolar depression are very few.
Common treatment for bipolar depression
Mood stabilizers such as Lithium and anticonvulsants like valproate and lamotrigine are typically used as treatments for bipolar depression “off label”, even though none of these drugs has been determined to be a first-line treatment that has been FDA-approved. Psychiatrists have consistently added an antidepressant for many years, to a mood stabilizer if by itself a mood stabilizer has proved to be ineffective; nevertheless, research has proven that antidepressants more often than not aren’t competent enough to deal with bipolar depression.
In an effort to improve behavior, mood, and social interactions, a mood-stabilizing medication is recommended and also in the prevention and treatment of bipolar mood states that shift from the highs of mania or hypomania to the lows of depression. Lamotrigine, carbamazepine, lithium and valproate are the most divergent antipsychotic drugs certified by the FDA in the treatment of more than one bipolar disorder phases according to the American Psychiatric Association.
In some subjects diagnosed with bipolar disorder, all that may be needed to regulate a depressed mood is a mood stabilizer. But in patients who don’t seem to be responding to one mood stabilizer, an atypical antipsychotic or another mood stabilizer can at times be required as an addition to their usual treatment routine.
Antidepressants in treatment of Bipolar Depression
Even though antidepressants are efficient in the treatment of people suffering from unipolar or major depressive disorder, this may not be the case for bipolar depression, hence they must not be prescribed alone in individuals with Bipolar I Disorder. Giving antidepressants to people with bipolar disorder shows a risk of igniting manic episodes in some of these patients. With this in mind, a majority of physicians might avoid the use of antidepressants for bipolar depression as monotherapy. A significantly sizeable randomized study known as the Systematic Treatment Enhancement Program for Bipolar Disorder indicated that there was a substantial improvement in 1 out of 4 people diagnosed with bipolar depression who were using a mood stabilizer and including an antidepressant with the mood stabilizer did not induce an increase in the chances for improvement. The study highlighted the necessity to find other treatments other than antidepressants and mood stabilizers for the treatment of bipolar depression.
Antidepressants must be used with the utmost precaution seeing as the use of an antidepressant by itself without adding a mood stabilizer may provoke a manic episode. Some experts also believe that use of antidepressants by people suffering from bipolar disorder with time has a mood destabilizing effects and can thus advance the frequency of depressive and manic episodes.
Antipsychotic medications for the treatment of bipolar depression
Research has proven that some antipsychotic drugs are efficient in treating bipolar depression. Seroquel XR and Seroquel are mainly used in treating depressive episodes affiliated with bipolar disorder. Symbyax is another drug that has shown to have rapid onset in treating bipolar depression which is a combination drug of the divergent Zyprexa (olanzapine), an antipsychotic and Prozac (fluoxetine) which is a selective inhibitor of serotonin reuptake and also an antidepressant. Latuda (lurasidone) an atypical antipsychotic drug is approved by the FDA for monotherapy or in conjunction with Valproate or Lithium in treating bipolar depression. Currently, these 3 medications are the only ones approved by the FDA for treating bipolar depression.
They work by influencing brain receptors concerned with behavior and mood and aiding in the restoration of the balance of particular natural chemicals in the brain or neurotransmitters. The physician should assess the risks and benefits of the medications available to enable you to enjoy some relief from the bipolar depression without the likelihood of drug interactions and/or mania.
The use of CNS depressants in bipolar depression assistance
Central Nervous System depressants act on the brain’s neurotransmitters in order to slow down typical brain function and this includes benzodiazepines. They are normally used in the treatment of sleep disorders and anxiety and can be an auxiliary therapy or a powerful alternative in some bipolar subjects with acute mania.
Some generally used benzodiazepines comprise of Diazepam/ Valium, Lorazepam/ Ativan, Clonazepam/ Klonopin and Alprazolam/ Xanax. These medicines have a tendency to be addictive and can result in lethargic thinking. They normally should only be used in treating sleep problems and agitation in the acute stage of the illness and not as long-term remedies. They should typically be diminished gradually as opposed to being stopped abruptly so as to decrease the chances of drug withdrawal.
The American Psychiatric Association’s protocol recommends Electroconvulsant therapy as a plausible alternative in subjects who may be suffering from psychosis or suicidal ideation. Additionally, Electroconvulsant therapy can assist women suffering from severe mania or bipolar depression who are pregnant.
In conjunction with bipolar depression medication, patients suffering from the same can benefit from continuous psychotherapy. Behavioral techniques in combination with interpersonal psychotherapy are what this one-on-one therapy entails in order to assist patients in learning how to reduce interpersonal problems, regulate their lifestyle habits and stay on their medications. The aforementioned Systematic Treatment Enhancement Program for Bipolar Disorder or STEP-BD study discovered that medication in addition to a systematic psychotherapy comprising of social/interpersonal rhythm therapy, cognitive behavioral therapy or family-oriented therapy may enhance a bipolar depression patient’s response to treatment by up to 150%.