Page "Bipolar disorder" Paragraph 45

Medications used to treat bipolar disorder are known as mood stabilizers ; these work by reversing manic or depressive episodes and preventing relapses.

The first known and " gold standard " mood stabilizer is lithium carbonate, which is effective in treating acute manic episodes, and preventing relapses, more so for manic than for depressive episodes.

Treatment with lithium carbonate has been strongly linked to a reduced risk of suicide, self-harm, and death in people with bipolar disorder.

Initially used as an anticonvulsant, sodium valproate has become a commonly prescribed treatment, and is effective in treating manic episodes.

Three other anticonvulsants are used in to treat bipolar disorder.

Carbamazepine became widely used to treat bipolar disorder in the late 1980s and early 1990s, but was displaced by sodium valproate in the 1990s.

Carbamazepine is effective in treating manic episodes, with some evidence it has greater benefit in rapid-cycling bipolar disorder, or those with more psychotic manic symptoms or a more schizoaffective clinical picture.

It is less effective in preventing relapse than lithium.

Lamotrigine has been shown to have some efficacy in treating bipolar depression, and this benefit is greatest in more severe depression.

It has also been shown to have some benefit in preventing further episodes, though there are concerns about the studies done, and is of no benefit in rapid cycling disorder.

The effectiveness of topiramate is unknown.

Depending on the severity of the case, anti-convulsants may be used in combination with lithium-based products or on their own.