If you have bipolar disorder , you probably know how important it is to take your medications exactly as prescribed by your doctor to keep your life in balance. But did you know that some of the herbs, vitamins, or supplements you take can have dangerous side effects when combined with your medications? Sometimes these things can reduce the effectiveness of your medications or cause serious side effects. So today, let's talk about this in a very simple way, in a way that you can understand.
First, let's see, what are the main types of medications given to bipolar patients?
Doctors use several types of medications to treat bipolar disorder, which is a condition where you feel very happy and energetic at times (called 'mania') and very sad and depressed at other times (called 'depression'). Some of these medications may have been prescribed for you.
Simply put, these medications can be divided into several main categories.
| Drug category | Examples (commonly used) |
|---|---|
| Mood Stabilizers | Lithium, which has been used for decades, is the most important of these. |
| Some medications for epilepsy (Anticonvulsants) | Valproic acid (Depakote), Carbamazepine (Tegretol), Lamotrigine (Lamictal) |
| Atypical Antipsychotics | Medications like Aripiprazole (Abilify), Olanzapine (Zyprexa), Quetiapine (Seroquel), Risperidone (Risperdal), Ziprasidone (Geodon). |
These medications are used to control the agitation and restlessness that occurs during the `Mania` or `Depression` phases of the disease. Some medications are given specifically for bipolar depression , while others are used long-term to prevent relapses.
Additionally, depending on your symptoms, your doctor may prescribe antidepressants, anti-anxiety medication, or sleeping pills.
Is it really safe to take these herbs and supplements with medication?
This is where many people get it wrong. Because they can buy these herbs and vitamins over the counter without a prescription, many people think that they are 100% safe.
Remember, not everything that says " natural " is "safe."
Think about it this way. Some weight loss supplements contain a plant called `Ephedra`. Taking this can cause symptoms of `Mania`, such as excessive happiness and lack of sleep. Also, `DHEA`, `SAMe`, `St. John's Wort` can also worsen `Mania`.
These herbs and supplements aren't tested and approved like drugs, so we don't know for sure what their risks are. If you mix the wrong herb with your bipolar medication, these dangerous things can happen:
- Internal bleeding in the body
- Excessively high or low blood pressure
- Liver damage
- Abnormal increase in heart rate
- Decreased effectiveness of the bipolar medications you take
What dangerous herbs are incompatible with bipolar medication?
This is a very important part. It is essential that you are aware of these things. Let's look at some examples.
| Incompatible herb/supplement | Types of medications that can cause side effects and what can happen |
|---|---|
| St. John's Wort (Some take it for mental well-being) |
|
| Ginkgo Biloba (Remembering) | It can reduce the effects of a medication like Depakote (valproic acid). |
| Evening Primrose Oil | It can sometimes be dangerous when taken with anticonvulsant medications like Lamictal . |
| Kava, Valerian, Gotu Kola (Taken for calmness, sleep) | When taken with anti-anxiety medications like Xanax, Klonopin, and Valium, it can cause excessive drowsiness and intoxication. This is very dangerous. |
Are these the only ones?
No. These are just a few examples. Research has found that there are more than 30 medications that can interact with herbs and supplements. The most common ones are sedatives and antidepressants . Both of these medications are commonly prescribed for bipolar disorder.
So how do I know if an herb I'm taking will interact with my medication?
The best and safest way to do this is to talk to your doctor. It's essential that he or she is aware of everything you're taking.
The best thing to do is, the next time you go to see your doctor, put every medication, vitamin, herb, and supplement you take (along with their bottles/packets) in a bag and bring it with you. Then the doctor can look at them and tell you exactly whether or not they are okay to take with your bipolar medication.
Never start a new herb or vitamin just because a friend told you to, or because you saw it on the internet. Also, never stop taking anything without first consulting your doctor.
Your main goal should be to manage your bipolar condition well and live an active, meaningful life. The best way to do that is to work with your doctor to develop a treatment plan that works for you.
If you experience a sudden severe reaction, for example, excessive drowsiness, loss of consciousness, or difficulty breathing, go to the nearest hospital Emergency Department (ETU) immediately. If necessary, you can also call the National Poisons Information Centre at the Colombo National Hospital for further advice.
Take-Home Message
- Never stop taking the medications your doctor has prescribed for your bipolar condition. Take them as prescribed.
- Tell your doctor about all the herbs, vitamins, supplements, and Ayurvedic medicines you are taking. Don't hide anything.
- Don't assume something is safe just because it's labeled "natural" or "herbal."
- Avoid starting any new herb or supplement without consulting your doctor.
- When visiting the doctor, it is very helpful to bring all the supplements and herbs you are taking along with their packets/bottles.
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