Medications are usually the first line of treatment for bipolar disorder. Mood stabilizers, antidepressants, and benzodiazepines may be part of the management plan on their own or in combination. Psychotherapy is also an effective strategy.

Finding the right medication or combination of medications for bipolar disorder symptoms may take some trial and error. A prescribing doctor may need to change medications due to side effects or adjust the dosage until you find relief.

It can take up to 8 weeks to see the full therapeutic effects of a bipolar disorder medication. This means that, even though you may start feeling relief immediately, you may not notice a significant change from one day to the next.

It takes time for your body to adjust and respond to a medication. It’s very important that you continue to follow the doctor’s instructions so you can achieve the treatment’s maximum effects.

Once a medication leads to symptom relief, you may transition into the maintenance part of your treatment. This means you’ll continue taking the same maintenance dose with a specific cadence.

A maintenance plan helps decrease the chance you experience severe bipolar disorder symptoms again, which may happen if you discontinue the medications.

Long-term treatment for bipolar disorder usually involves a combination of medication and talk therapy.

The following types of medications may be used to manage symptoms of bipolar disorder:

Lithium (Lithobid) is a mood-stabilizing drug that’s been used since the 1970s. It helps manage symptoms of acute mania. It’s also effective at preventing the recurrence of periods of mania and depression.

Mania is a period of heightened or elevated mood that typically involves low impulse control, decreased need for sleep and rest, and a sense of being invincible.

Common side effects of lithium include unwanted weight gain and digestive issues. The drug can also affect the thyroid and kidneys. Periodic blood tests are usually added to the management plan to monitor the possible effects of lithium on your body.

Lithium may or may not be part of your treatment if you’re pregnant or nursing. The drug can cross the placenta and reach the fetus. It can also be passed through breast milk.

If you are pregnant or planning to be, it’s important to discuss the possible risks and benefits of lithium therapy. A doctor can tailor the treatment based on your medication history, specific symptoms, how far along you are in your pregnancy, and other individual factors.

Anticonvulsants or antiepileptic medications are approved to prevent and manage seizures. However, they also have a stabilizing effect on your mood. In some cases, a doctor will prescribe an anticonvulsant to manage symptoms of bipolar disorder.

Common anticonvulsants used in bipolar disorder include:

Common side effects of anticonvulsants include unwanted weight gain, drowsiness, and an inability to sit still. Serious effects are also possible, particularly during pregnancy and nursing. Before starting your treatment, consider asking the prescribing healthcare professional about all possible risks and how you should monitor those.

Antipsychotic drugs help manage symptoms of psychosis, like hallucinations and delusions. But they may also be used for other conditions, including some symptoms of bipolar disorder.

Antipsychotic medications may help with acute symptoms of mania or for the long-term management of mood episodes (changes in your mood). In other cases, when bipolar disorder manifests with temporary symptoms of psychosis, they can also help.

Some antipsychotics used in bipolar disorder include:

Common side effects include unwanted weight gain, drowsiness, dry mouth, decreased sex drive, and blurred vision. Antipsychotics may also affect memory and attention and may cause involuntary facial or body movements.

Antidepressant medications include:

Antidepressants may help manage depressive episodes in bipolar disorder, but they may not be useful in all cases. Some antidepressants may trigger manic episodes. To reduce this risk, doctors frequently prescribe antidepressants with a mood stabilizer or antipsychotic medication.

Common SNRIs include:

Common SSRIs include:

Common MAOIs include:

  • phenelzine (Nardil)
  • tranylcypromine (Parnate)

MAOIs are rarely prescribed for bipolar disorder unless other medications have not worked. Common side effects include reduced sexual desire, sleep disturbances, increased appetite, dry mouth, gastrointestinal troubles, and menstrual problems.

Common TCAs include:

When taking an antidepressant, it’s important to avoid other medications that affect serotonin levels in the brain, as it may lead to a serious condition known as serotonin syndrome.

If you’re taking MAOIs, foods high in tyramine or some medications may lead to severe high blood pressure. Foods high in tyramine include aged cheeses, processed meats, and overripe or dried fruits.

Read more about MAOIs and tyramine.

Benzodiazepines are anti-anxiety medications used mostly for short-term treatments, as they have a high chance of creating dependence. They may help in severe cases of manic episodes.

Benzodiazepines may include:

Side effects may include drowsiness, reduced muscle coordination, and problems with balance and memory.

What is the best medication for bipolar disorder?

The “best” medication to manage bipolar disorder is the one that responds to your individual needs, relieves your symptoms, and causes the least side effects. This could be different for everyone. A prescribing doctor will work with you to adjust the dosage and switch medications, if needed, until you find relief.

What medications should people with bipolar disorder avoid?

Only a healthcare professional can tell you which medications to take or avoid for bipolar disorder. Some doctors may want you to avoid antidepressants if you have manic episodes, or they may ask you to take them in combination with other medications. What medications you need to avoid depends on your type of bipolar disorder, current symptoms, overall health status, and individual needs.

What is the most common drug for bipolar disorder?

Mood stabilizers are frequently a part of the treatment for bipolar disorder. They help reduce and prevent mood episodes. Often, a healthcare professional may prescribe mood stabilizers together with another type of medication, depending on your symptoms and needs.

Medications are the first line of treatment for bipolar disorder. They can help reduce mood changes, psychosis episodes, and intensification of symptoms. Doctors may prescribe more than one type of medication and explore different dosages until you feel relief from your symptoms.

Common medications for bipolar disorder may include mood stabilizers, antidepressants, antipsychotics, and anticonvulsants. Some of these medications may cause severe side effects or interact with foods and other drugs. It’s important to ask the prescribing doctor about the possible risks and how to manage those.