Do you or someone you know have bipolar disorder ? If so, your doctor may have prescribed a type of medication called an 'Antipsychotic'. You may be a little scared when you hear this name. You may think, 'What do I need a medication for psychosis for?' But in fact, this medication can help a lot in controlling bipolar disorder. This is just another step in your journey. So today, let's put aside all the questions and fears about this and talk simply.
Why are 'Antipsychotic' medications prescribed for bipolar disorder?
Think of it this way: the mood of someone with bipolar disorder is like a seesaw. One moment, they go from high to low (this is called mania) to low to high (this is called depression). Antipsychotic medications help to balance the two extremes of the seesaw by controlling the rapid swings.
Simply put, this medicine mainly helps:
- Control mania: These help control episodes of inattention , hyperactivity, impulsive decisions, and lack of sleep.
- Control psychotic symptoms: Sometimes, with mania or severe depression, you may experience hallucinations and delusions. These medications are very important to quickly control these symptoms.
- Prevent relapse: Using this medication long-term can reduce the risk of future episodes of mania or depression.
- Helps with other things too: Sometimes doctors may prescribe this medication in low doses for insomnia, excessive anxiety , or agitation.
How does this medicine work?
Our brains have brain circuits that control our thoughts, moods, and how we perceive things. These medications work by regulating the activity of those circuits. Although exactly how this happens is still in the research stage, it is clear that these medications can quickly control manic symptoms.
These medications are often given in combination with other medications, such as the mood stabilizer lithium. These antipsychotic medications help to control symptoms quickly until the other medications start working properly.
But for some people, if medications like lithium don't work, your doctor may decide to use these antipsychotic medications alone long-term. The newer atypical antipsychotics , in particular, work very quickly. Your thoughts should start to return to normal within a few weeks.
What medications are used for bipolar disorder?
There are several types of 'Antipsychotic' medications used for bipolar disorder in Sri Lanka and around the world. Your doctor will choose the medication that is most suitable for you. The table below lists some of the most commonly used medications.
| Generic Name of the Medicine | Common brand name |
|---|---|
| Aripiprazole | Abilify |
| Asenapine | Saphris |
| Cariprazine | Vraylar |
| Clozapine | Clozaril |
| Lurasidone | Latuda |
| Olanzapine | Zyprexa |
| Quetiapine | Seroquel |
| Risperidone | Risperdal |
| Ziprasidone | Geodon |
The story that everyone fears: Let's learn about side effects
Okay, now let's talk about a topic that many people are afraid of. That is side effects. Remember, any medication can have minor side effects. The most important thing is to not be afraid of this, to be aware of it, and to talk openly with your doctor about anything.
Some antipsychotic medications can cause weight gain, high blood cholesterol levels , and an increased risk of developing diabetes. This is a concern for many people. That's why your doctor will check your weight, height, blood sugar, and cholesterol levels before you start taking these medications. These will be monitored regularly during treatment.
Other common side effects
- Blurred vision
- Dry mouth and throat
- Daytime sleepiness
- Muscle twitching or shaking
- Weight gain
Special Note: Clozapine (Clozaril) is not commonly used because of its rare, potentially life-threatening side effects (decreased white blood cell count). If you are taking this medication, you should be closely monitored with weekly or biweekly blood tests as directed by your doctor. Ziprasidone (Geodon) has also been associated with a rare, serious skin condition. Your doctor knows all about this, so don't worry. He or she will monitor you closely.
Should we also learn about older antipsychotics?
There are also older medications, such as Chlorpromazine (Thorazine) and Haloperidol (Haldol). However, these are no longer recommended as first-line treatments for bipolar disorder. The main reason for this is that long-term use of these older medications increases the risk of a serious side effect called tardive dyskinesia .
Tardive Dyskinesia is a condition in which you have involuntary movements such as lip smacking, tongue sticking out, facial grimacing, and uncontrollable shaking of the arms and legs.
But don't worry, the new drugs we talked about earlier (atypical antipsychotics) have a much lower risk. That's why doctors are now giving priority to those drugs. If this condition does occur, there are now medications like Deutetrabenazine (Austedo) and Valbenazine (Ingrezza) to treat it.
Take-Home Message
- Antipsychotic medication is a very important and effective treatment for controlling mania and psychotic symptoms in bipolar disorder.
- Before starting and while using this medication, talk openly with your doctor about side effects, especially weight gain and diabetes risk.
- Never stop taking your prescribed medication or change the dosage without your doctor's advice. Doing so may cause your symptoms to return more severely.
- If you notice any unusual side effects (especially uncontrollable body movements, excessive sleepiness, or anything else), inform your doctor immediately.
- This medicine is a help to restore your mental well-being. So, without fear or doubt, discuss everything with the doctor and get treatment with confidence. You can go on this journey.
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