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Phil asked...

What is the best treatment for bipolar?

Is it better to be on lithium or tegretol for bipolar disorder?

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The answer

Most patients suffering with Bipolar can be treated with a combination of different medicines depending on diagnosis and severity.

These include:

  • Mood stabilisers taken for mania and hypomania (less severe mania which are taken daily, for long term use).
  • Medication to treat main depressive symptoms when they occur.
  • Learning to recognise triggers of symptoms.
  • Psychological treatment e.g. talking therapy.
  • Lifestyle advice e.g. regular exercise, improving your diet and getting more sleep.

Mood stabilising medicines include:

  • Lithium carbonate
  • Anticonvulsant medicines
  • Antipsychotic medicines

If response to antipsychotics is inadequate, lithium or valproate may be added. However antipsychotics can be used concomitantly with lithium or valproate in initial treatment.

In the UK, lithium carbonate (often referred to as just lithium) is the medication that is most commonly used to treat bipolar disorder. Lithium is a long-term method of treatment for episodes of mania, hypomania and depression. It is usually prescribed for at least six months. The decision to give preventative lithium requires specialist advice, as it must be based on careful consideration of the likelihood of recurrence in the individual patient, and the benefit of treatment weighed against the risks.

Carbamazepine may be used under specialist supervision for the prevention of bipolar disorder in patients unresponsive to a combination to other preventative medicines.  It is used in patients with rapid cycling manic depressive illness or more affective episodes per year. To begin with, the dose will be low and then gradually increased. Blood tests to check your liver and kidney function will be carried out when you start taking carbamazepine, and again after six months. You will also need to have a blood count (at the start and after six months), and you may also have your weight and height monitored

It would be prudent to speak to your GP or physician whom will assess your symptoms and prescribe the appropriate treatment under the recommendation guidelines.

Answered by Health at Hand nurses.


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