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Anxiety and Stress Disorders

Medication for Bipolar Disorder

09/27/2005

Question:

I need to get some answers as I`m about to marry someone who has what he calls "a-typical bipolar depression". He`s taking 2 kinds of medications, Celexa and Zyprexa. I need to know if it`s possible that he doesn`t have schizophrenia but is taking Zyprexa for anxiety? The 2 medications he`s taking he said is for anxiety and depression. This is very important for me to know. Your help would be greatly appreciated. Thank you in advance.

Answer:

Bipolar disorder, previously known as "manic-depressive" illness is a common mental illness that affects about 2 million people each year.  Bipolar disorder is a brain disorder that causes unusual shifts in a person's mood, energy, and ability to function. Different from the normal ups and downs that everyone goes through, the symptoms of bipolar disorder can be severe.

Bipolar disorder can be effectively treated with medications and talking therapy (psychotherapy), usually in conjunction with each other.  Bipolar disorder is usually a chronic illness, and medication is generally continued for years, if not for life.  The main class of medication used is called "mood stabilizers."  The classic mood stabilizer for bipolar disorder was lithium, but over the last decade many excellent newer mood stabilizers have been developed, and medications originally developed for other purposes (predominantly for seizure disorders or epilepsy) have been found to be very effective in bipolar disorder.  Some of these include: valproate (Depakote) or carbamazepine (Tegretol),  lamotrigine (Lamictal), gabapentin (Neurontin), and topiramate (Topamax).   Antidepressants, such as the selective serotonin reuptake inhibitors (SSRIs) are often added to help with the depression component.  (Celexa is such an antidepressant).  The major antipsychotic medications, such as clozapine (Clozaril), olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel), and ziprasidone (Geodon) are being studied as possible treatments for bipolar disorder. Zyprexa, especially has been studied as an option for people who don't respond well to mood stabilizers and may serve as an effective treatment for acute mania and psychotic (or extremely severe) depression.

Mental illness is a disease that affects the family.  I strongly encourage family members of patients with bipolar disease to accompany the patient to some appointments with physicians and mental health professionals.  It is important to learn how bipolar disease will affect relationships and the ability of the affected person to interact socially.  With treatment and support, mentally ill people can and do have wonderful and loving significant relationships and contribute to society in many ways.  Good luck.

Check out the NIH NIMH website on bipolar disorder for an excellent review of this illness.

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Response by:

Nancy   Elder, MD Nancy Elder, MD
Associate Professor
College of Medicine
University of Cincinnati