What if a medication isn’t helping bipolar get better?

Bipolar disorder has a reputation for being very biological. Many clinicians even think that it’s basically a situation of the medicine works or the medicine doesn’t work.

Most coronations, see treatment as biological, psychological and social. So if the medicine doesn’t work, they will think is there something psychological or social going on? This is why you go to an astute experienced clinician. They are turning over every rock, exploring every kind of issue that might be contributing to an anti-depressant or mood stabilizer not working in bipolar disorder.

Antidepressants usually don’t work in bipolar disorder and can stop mood stabilizers from working. in the late 1900s, antidepressants were often combined with lithium or Depakote and sometimes they helped the depression get a little bit better but after a year or two, the patient was right back where they started. And that often happened with lithium. It could help the depression get someone better in the mania get somewhat better, but after 2 to 5 years That patient is often right back where they started. Of course there are some exceptions to this. Lithium is often Goodwin added to other mood stabilizers to help with bipolar depression.

Bipolar disorder is a completely different thing than major depression.

That being said, Depression is still the main problem in bipolar disorder. We have good treatments for mania, and they include mood stabilizers like Abilify, olanzapine, Seroquel, Risperdal, and a new medicine, Villar, and another new medicine cap Lida.

Common combinations of medicine to help with bipolar, depression include, Abilify and lamotrigine, olanzapine, and Prozac, and, and it should be noted that lamotrigine is approved for preventing a reoccurrence of mania or depression, but primarily depression. It’s not approved for treating the depression once it happened. And it rarely does anything for a mania once that has occurred. Mania often breaks through lamotrigine so I will add an anti-manic medicine to be used on as needed basis in some cases.

You can search the Internet with the question quote FDA approved treatment for bipolar, depression,“ and you can see what the latest in medical sciences. is.

The main approach now with bipolar disorder, to treat depression, is to try to use one or two medication’s. Capita, Var, and Abilify all are good choices. If the depression gets somewhat better, let’s say 50%, then I commonly stick with that first medicine, but augmented with another medicine.

It’s important to treat the whole person. Certain medicines like olanzapine can potentially cause a 20 to 40 pound weight gain or even cause diabetes. Still it is a good medicine and if necessary I’ve prescribed it with Prozac and seen it do a good job. Weight gain can be treated with Met Forman and exercise and that works about 50% of the time.

Seroquel and Abilify can cause weight gain, but it is usually minimized with metformin.

Many people with bipolar self medicate with food, and so obesity becomes an issue that adds to the depression. I’ve referred people to nutritionist, recommended the active, socially, and with physical sports. And met Forman and other medicines can be dramatically helpful For these people, who are moving, and eating healthier. That means cutting way back on carbs and almost totally cutting out fast food and processed food.

Psychotherapy and learning social skills are a great ways to combat loneliness, which is a common contributor to depression. When people can open up with a group of friends and have rewarding experiences, that’s the best treatment for depression there is.

I’ve also seen mood stabilizers help much more for depression when underlying medical conditions are treated, such as: hypothyroidism, obesity, diabetes, sleep apnea, neuralgia, among other medical conditions. Again you have to treat the whole person in the brain is connected to the rest of the body so it’s important to keep that in mind. Medicine has a fault nowadays in being so one dimensional with specialists just looking at what’s in their specialty. It’s important to think about the whole person, biologically, psychologically and socially.

With that being understood, I’ve seen mood stabilizers help more for depression, whensome of these medicines have been added: low-dose, bupropion, low-dose, trazodone, low-dose, anti-anxiety medicines like gabapentin or boost bar, bright light therapy for those with seasonal depression, daily exercise, daily meditation, to experience, deep, self acceptance, among other biological, psychological and social interventions.