Most people who have bipolar disorder will need a combination of medication and therapy to help manage their symptoms. The main feature of bipolar disorder is intense mood episodes, and some people may also experience psychosis, which is a break with reality that may involve hallucinations or delusions. Different types of antipsychotics can help with all of these symptoms. They may be used instead of mood stabilizers or in combination with them. Psychotherapy is also important for learning strategies to manage intense emotions and energy fluctuations.
In this article, we’ll talk about how antipsychotics help with the symptoms of bipolar disorder and why a relationship with a medication management provider is critical for the best outcomes.
Understanding bipolar disorder
Bipolar disorder is not one condition, but several symptom patterns that share similar features. People with bipolar disorder experience either mania or hypomania. Manic episodes are characterized by feelings of high energy or invincibility. In some cases, mania may trigger a break from reality. Hypomania is a less intense version of that. In addition to mania or hypomania, people with bipolar disorder also experience depressive episodes. These come with similar symptoms to major depressive disorder. People cycle through these symptoms at different rates depending on the type of bipolar disorder they have.
Here’s a breakdown of the different types of bipolar disorder:
- Bipolar 1 — People receive this diagnosis after having at least one manic episode. This may come before or after hypomanic or major depressive episodes.
- Bipolar 2 — People with this diagnosis experience both depressive and hypomanic episodes, but not mania.
- Cyclothymic disorder — In this type, people have many periods of hypomania and depression that don’t meet the full criteria for a mood episode.
There are other mood patterns and related disorders that may be caused by certain drugs, alcohol or medical conditions — for example, Cushing’s disease, multiple sclerosis or stroke. Some people have mixed mood episodes with symptoms of both depression and mania or hypomania. Rapid cycling is when a person experiences four or more mood episodes in a year.
What are antipsychotics?
Antipsychotics are a type of medication that treats symptoms of hallucination and delusion. This is when people see, hear or feel things that aren’t there or believe things that aren’t true. Some antipsychotics can also help manage mania and other mood symptoms related to bipolar disorder. These medications are often used to treat acute episodes. They can also be taken for long-term mood management. Mood stabilizers (e.g., Lithium, Depakote, Lamictal) are typically the first-line treatment for bipolar disorder. When these aren’t suitable or when they aren’t effectively reducing all symptoms, antipsychotics may be added.
Some antipsychotics used to treat bipolar disorder include:
- Aripiprazole (Abilify)
- Lumateperone (Caplyta)
- Lurasidone (Latuda)
- Olanzapine (Zyprexa)
- Quetiapine (Seroquel)
- Risperidone (Risperdal)
Most antipsychotics work by reducing the availability of dopamine in the brain. First-generation or typical antipsychotics primarily affect dopamine. Second-generation or atypical antipsychotics also affect serotonin and other neurotransmitters. Next-generation antipsychotics may not act directly on dopamine. They attach to specific acetylcholine receptors that affect memory and cognition.
Benefits and risks of antipsychotics for bipolar disorder
The key benefits of antipsychotics are a reduction of psychotic symptoms, prevention of manic episodes and mood stabilization. There are often no other alternatives that can provide the same relief. Besides bipolar disorder, some antipsychotics are also used to treat schizophrenia, acute psychosis with other causes, and other conditions.
Antipsychotics have some known side effects and interactions with other medications. Weight gain and movement disorders are possible. However, antipsychotics are sometimes used off-label to treat movement disorders and related conditions. These include Parkinson’s disease, Huntington’s disease, Tourette syndrome and others.
The potential side effects of antipsychotics include:
- Movement disorders
- Weight gain
- Dizziness and sedation
- Heart problems
- Metabolic symptoms and diabetes
- High prolactin levels
- Immune dysfunction
- Jaundice
- Painful muscle contractions
- Urinary retention
- Dry mouth
- Constipation
The role of medication management
People who have bipolar disorder need personalized, ongoing treatment to manage their symptoms. This usually includes medication management and therapy with qualified providers. They may need to try a few different medications before finding a combination that works. Forming a relationship with an experienced prescriber is critical for long-term well-being. You should look for a provider you trust and someone you feel comfortable talking to.
Virtual platforms have made this process much easier and more accessible. Seeing your prescriber online means you can attend appointments from anywhere. You also have more providers to choose from. This way, you can prioritize things like cultural sensitivity and personality fit.
Find a medication management provider who understands your symptoms at ReKlame Health
Bipolar disorder affects virtually every part of your life. There are a lot of factors to consider when making the decision to try medication. Antipsychotics and mood stabilizers can go a long way to help you manage your symptoms when used properly. Partnering with a provider who gets you and understands your symptoms makes all the difference.
At ReKlame, we offer personalized, culturally relevant medication management for complex conditions. We can match you with a psychiatric nurse practitioner who has experience treating bipolar disorder. You can expect a supportive relationship with a provider who listens and addresses your concerns.
Ready to start the conversation? Appointments are available now. Check your eligibility for free online or book an initial appointment online.
