Medications for Bipolar Disorder

Bipolar disorder is a chronic mental health condition characterized by extreme mood episodes that alternate between manic (or hypomanic) highs and depressive lows, with periods of relative stability in between. During a manic episode, a person may feel euphoric, have an inflated sense of self-worth, need very little sleep, speak rapidly, and engage in impulsive or risky behaviors — severe mania can also involve psychosis. Depressive episodes in bipolar disorder resemble major depression, featuring persistent sadness, fatigue, loss of interest, difficulty concentrating, and suicidal thoughts. Bipolar disorder affects approximately 4.4% of U.S. adults at some point in their lives and has a strong genetic component; it typically first appears in the late teens or early 20s. There are several types, including Bipolar I (full manic episodes), Bipolar II (hypomanic episodes with major depression), and cyclothymia.

Bipolar disorder significantly disrupts relationships, employment, and quality of life when not well managed, and carries a high risk of suicide, making accurate diagnosis and consistent treatment essential. Substance use disorders and anxiety disorders frequently co-occur with bipolar disorder, complicating management. Treatment focuses on stabilizing mood over the long term: mood stabilizers such as lithium and valproate (divalproex) reduce the frequency and severity of mood episodes; atypical antipsychotics are used for acute mania and as long-term mood stabilizers; and antidepressants, when used, are typically combined with a mood stabilizer to reduce the risk of triggering a manic episode. Psychotherapy — particularly psychoeducation and CBT — is an important complement to medication. The medications listed below are among the most commonly prescribed for managing bipolar disorder.