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Medications For Bipolar

  • Apr 8
  • 2 min read

Updated: Apr 9

Presentation from Royal Edinburgh Hospital pharmacists on different medication treatments for bipolar disorder


Brain food

April Meeting: Medications For Bipolar


This month, we were joined by lead clinical pharmacist Paul Maguiness and specialist pharmacists Jennifer Falconer and Morven Forsyth from the Royal Edinburgh Hospital to discuss bipolar medication. Their presentation explored the different medication types for bipolar treatment and how they are used for episodes of acute mania, episodes of acute depression, and relapse prevention. Read the highlights from the presentation below or download their full presentation using the link at the bottom.


Types of Medications

Antipsychotics (Second Generation)

  • Quetiapine – mania, depression and preventing relapse ​

  • Olanzapine – mania, depression, preventing relapse ​

  • Risperidone, Aripiprazole – mania, preventing relapse, effective in acute illness ​

  • Lurasidone – bipolar depression (unlicensed) ​

  • Cariprazine – mania, depression (unlicensed)

Mood Stabilizers

  • Lithium

  • Valproate

  • Lamotrigine

  • Carbamazepine

Antidepressants

  • SSRIs (Selective Serotonin Reuptake Inhibitors) - Sertraline, Citalopram, Fluoxetine

  • SNRIs (Serotonin–Noradrenaline Reuptake Inhibitors) - Venlafaxine, Duloxetine

  • TCAs (Tricyclic Antidepressants) - Amitriptyline, Nortriptyline, Imipramine

  • MAOIs (Monoamine Oxidase Inhibitors) - Phenelzine, Moclobemide

  • NaSSAs (Noradrenergic and Specific Serotonergic Antidepressants) - Mirtazapine

  • SARIs (Serotonin Antagonist and Reuptake Inhibitors) - Trazodone

  • Others - Vortioxetine, Bupropion, Agomelatine



Recommended Medication Treatment

Acute Manic Episode

  • Antipsychotics

  • Mood stabilizers (Lithium, Valproate)

  • Benzodiazepines

Acute Depressive Episode

  • Antipsychotics

  • Mood stabilizers

  • Antidepressants

Relapse Prevention/Maintainance

  • Antipsychotics

  • Valproate

  • Carbamazepine

  • Antidepressants


Key takeaways

  • Antipsychotics are the 1st line of treatment for mania

  • Lithium is 1st line of treatment for long term prevention

  • Valproate is considered a better treatment option for mania

  • Antidepressants have a risk of increasing mania/hypomania

  • Medication treatment requires physical health monitoring


Additional information and resources

Check out our Resources page for additional information and resources about bipolar.

You can also view the NHS handy chart for more information on bipolar medications.



Presentation Slides



 
 
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