Second Generation Mood Stabilizers
Atypical antipsychotic drugs have been used extensively for the management of acute mania in the last several years. Emerging data suggests that drugs like risperidone, olanzapine, quetiapine, etc., are highly efficacious, with almost similar antimanic efficacy. These agents have demonstrated effectiveness as a substitute for lithium and are used in combination with mood stabilizers.
However, there is a shortage of data pertaining to their effectiveness in acute bipolar depression and maintenance treatment. Further, the available data needs to be simulated in future studies before establishing quetiapine as a gold standard of treatment for acute bipolar depression.
A 6-month duration study showed that aripiprazole could be effective in the prophylaxis of manic episodes, however, further studies with at least a duration of 12 months and having a large sample size are needed to establish this agent for the prevention of bipolar disorder.
And now, it is not known if ziprasidone, aripriprazole, and risperidone are effective in treating the symptoms of acute bipolar depression. Therefore, studies with longer duration and a larger sample size are warranted.
In general, the atypical antipsychotics are safe and effective medicinal agents for managing bipolar disorder.
- Lamotrigine : An antiepileptic agent which has been recently declared as a standard treatment mechanism for the management of symptoms of bipolar disorder. It has been suggested that lamotrigine has the potential to alleviate an individual’s depressive symptoms without affecting their overall mood and without exacerbating the symptoms of mania. Nevertheless, it is a relatively new agent for the treatment of bipolar disorder, therefore, additional research is warranted to establish its effectiveness. In addition, researchers also need to establish if this agent can be taken in monotherapy or in combination therapy.
Effectiveness of Mood Stabilizers
Like any other medicine, mood stabilizers are the most effective when taken under the supervision of a registered mental health specialist and when one strives their best to remain compliant to the dosing schedule.
Further, the use of mood stabilizers should neither be stopped suddenly nor without medical supervision. Sudden cessation of these drugs, even when the mood appears to be stabilized, can lead to a relapse, introducing avoidable complications in the treatment plan.