Cyclothymia (Treatments)

Medications for the disorder are prescribed by psychiatrists. While primary care physicians who do not specialize in psychiatry also may prescribe medications, it is preferred that people with bipolar disorder see a psychiatrist for treatment.

"Mood stabilizers" usually are prescribed to help control bipolar disorder. Several different types of mood stabilizers are available. In general, people with bipolar disorder continue treatment with mood stabilizers for extended periods of time. Other medications are added as required, typically for shorter periods, to treat episodes of mania or depression that break through despite the mood stabilizer.

Lithium, approved for the treatment of acute mania in 1970 by the U.S. Food and Drug Administration (FDA), has been an effective mood-stabilizing medication for many people with bipolar disorder.

Anticonvulsant medications, particularly valproate and carbamazepine, have been used as alternatives to lithium in many cases. Newer anticonvulsant medications, including lamotrigine, gabapentin and topiramate, are being studied to determine their efficacy as mood stabilizers in bipolar disorder. Some research suggests that different combinations of lithium and anticonvulsants may be helpful.

Children and adolescents with bipolar disorder generally are treated with lithium, but valproate and carbamazepine are helpful as well. Researchers are studying the safety and efficacy of these and other psychotropic medications in children and adolescents. There is some evidence that valproate may lead to adverse hormone changes in teenage girls and polycystic ovary syndrome in women who began taking the medication before age 20. Therefore, young female patients taking valproate should be monitored carefully by a physician.

Women with bipolar disorder who wish to conceive, or who become pregnant, face special challenges due to the possible harmful effects of existing mood stabilizing medications on the developing fetus and the nursing infant. The benefits and risks of all available options should be discussed with a clinician skilled in this area. New treatments with reduced risks during pregnancy and lactation are currently being studied.

Changes to the treatment plan may be needed at various times. A psychiatrist should guide any changes in type or dose of medication.

Be sure to tell the psychiatrist about all other prescription drugs, over-the-counter medications, or natural supplements you may be taking. This is crucial because certain medications and supplements mixed together may cause adverse reactions. To reduce the chance of relapse, it is wise to stick to the treatment plan. Talk to your doctor if you have any concerns about the medications.

As an addition to medication, psychosocial treatments—including certain forms of psychotherapy (or "talk" therapy)—can provide support, education, and guidance to those struggling with bipolar disorder and their families. Studies have shown that psychosocial interventions can lead to increased mood stability, fewer hospitalizations, and sharper functioning in several areas. A licensed psychologist, social worker, or counselor typically provides these therapies, often working with the psychiatrist to monitor a patient's progress. The number, frequency, and type of sessions should be based on the treatment needs of each person. Certain types of psychotherapy or other interventions, in combination with medication, can offer additional benefit. These include cognitive-behavioral therapy, interpersonal and social rhythm therapy, family therapy and psychoeducation.