• Mental Health

What’s the Best Medication for Bipolar Disorder? A Guide to Treatment

Published: April 24, 2025
Updated: April 24, 2025
4 mins

Bipolar disorder is one of the most misdiagnosed lifelong mental health conditions out there. In 2019, an estimated 40 million people were living with bipolar disorder. Unfortunately, the stigma attached to bipolar disorder often discourages people from reaching out for treatment. Still, there are plenty of options for treating bipolar disorder in a way that works for you. 

Every individual with bipolar disorder has an experience unique to them. A healthcare provider may consider several medications and methods of treatment before prescribing you medicine to treat bipolar disorder. Your treatment journey with bipolar disorder may change over time as the body adjusts to medications and other treatment methods.

What are the Symptoms of Bipolar Disorder?

The most common signs of bipolar disorder are intense mood swings, energy shifts, and a loss of interest in pleasurable activities. Mood swings associated with bipolar disorder can look like a feeling of intense happiness, sadness, or extreme irritability in a short amount of time.

What are the Different Types of Bipolar Disorder?

The two main types of bipolar disorder are bipolar type I and bipolar type II disorder. Those with bipolar type I experience manic and depressive episodes, whereas those with bipolar type II do not have a history of manic episodes. Cyclothymic disorder is a less common type of bipolar disorder that can lead to depressive episodes for a year or two in adults and children.

Why is Bipolar Disorder Managed with Medication?

Health experts believe the best way to manage bipolar disorder is with a combination of psychotherapy and medication. Don’t stress if your first treatment plan needs tweaks. It’s not unusual to try out several different types of therapy and medications before finding the right combination that works for you. 

Different bipolar medications target certain neurotransmitters responsible for managing your mood and changing emotions. A healthcare provider may prescribe more than one medication at a time to target both manic episodes and depression.

Can You Combine Medications for Bipolar Depression?

It’s not uncommon for a healthcare provider to recommend using different medications together to regulate mood. Mood stabilizers are often used in conjunction with antidepressants and antipsychotic medications to prevent rapid cycling. Rapid cycling is when someone experiences four or more manic episodes within a twelve month period.

What Class of Medications Treats Bipolar Disorder?

A healthcare provider may adjust dosage and alter treatment plans based on how the body responds to them. The main types of bipolar medications include mood stabilizers, antidepressants, and benzodiazepines.

It’s important to keep taking medications for bipolar medication as instructed by your healthcare provider, even if you start to feel better. Stopping treatment abruptly may reduce the effectiveness of the medication. The dosages for each of these medications tend to vary, but start on the lower end to help the body adjust. 

Mood Stabilizers for Bipolar Disorder

Mood stabilizers are primarily prescribed to help manage manic episodes. They can also help treat depression. However, mood stabilizers may take a couple of weeks to become effective. Several mood stabilizers may affect the body differently. 

Common mood stabilizers treating bipolar disorder include:

• Lithium: A mood stabilizer used with other medications or alone to treat manic episodes.

• Divalproex: An antiseizure medication that treats manic episodes, seizures, and migraines.

• Lamotrigine: An anti-seizure medication that also helps to manage bipolar symptoms.

• Carbamazepine: Carbamazepine is often prescribed as part of a treatment plan with other medications to manage manic episodes, seizure disorders, and trigeminal neuralgia (intense nerve pain around the face).

What are the side effects of mood stabilizers?

Most mood stabilizers are available as a tablet, capsule, chewable tablet, or liquid. Mood stabilizers may increase the risk of heart issues in those over 60. Other side effects people of any age may experience while taking mood stabilizers include:

• Nausea

• Vomiting

• Weight gain

• Diarrhea

• Abdominal pain

• Headache

• Rash

Be sure to let your healthcare provider know if you are pregnant or plan on becoming pregnant in the near future. Your healthcare provider may alter your treatment to prevent any pregnancy complications.

Antipsychotics for Bipolar Disorder

Antipsychotics to treat bipolar disorder are often referred to as atypical antipsychotics. They work by altering the activity of certain neurotransmitters in the brain. The four main antipsychotics prescribed to those with bipolar disorder include the following:

• Olanzapine (Symbax): Dosage for olanzapine typically starts at 3 to 6 milligrams (mg) per day. It’s primarily used to treat depressive episodes associated with bipolar disorder.

• Risperidone: Balances dopamine and serotonin in the brain to improve decision-making, mood, and behavior. Dosages typically range from 1 to 6 mg per day.

• Quetiapine (Seroquel): An FDA-approved medication for treating manic and depressive episodes, sleep issues, and schizophrenia. It’s available as both an extended-release and immediate-release tablet. Dosages for adults taking quetiapine range from 400 to 800 mg a day.

• Lurasidone (Latuda): A medication approved for the treatment of schizophrenia and bipolar depression. Lurasidone alters neurotransmitters like dopamine and serotonin in the brain. Dosages of lurasidone range from 20 to 120 mg a day for bipolar depression. Lurasidone is often associated with fewer side effects than risperidone, quetiapine, and olanzapine.

What are the side effects of antipsychotics?

Antipsychotics may increase the risk of dementia-related psychosis and potentially death in elderly people with dementia. Other potential side effects a person may experience while taking antipsychotics include:

• Dizziness

• Hormonal imbalance

• Hallucinations

• Delusions

• Insomnia

• Fatigue

• Arrhythmia (irregular heartbeat)

• Suicidal thoughts

 Antidepressants for Bipolar Disorder

Health experts have varied opinions on the effectiveness of antidepressants as part of a treatment plan for bipolar disorder. Some health experts believe the quick switch from depression to mania may be harmful in the long run because of the risk of rapid cycling. Still, health experts have found that antidepressants can help relieve bipolar depression symptoms in the short term.

SSRIs (selective serotonin reuptake inhibitors) are antidepressants that produce more serotonin in the brain to improve mood. Antidepressants are often prescribed with mood stabilizers. SSRIs are available as tablets, capsules, and liquids. Your healthcare provider may prescribe the following antidepressants with other medications:

• Citalopram (Celexa): The primary purpose of citalopram is to treat depressive symptoms. It’s also used to treat obsessive-compulsive disorder (OCD), social anxiety disorder, and posttraumatic stress disorder (PTSD). Citalopram dosages typically range from 20 to 40 mg daily.

• Sertraline (Zoloft): A medication treating major depressive disorder, OCD, PTSD, and other mental health conditions. Sertraline increases serotonin levels. Sertraline dosages vary from 35 mg to 200 mg daily.

• Escitalopram (Lexapro): Escitalopram treats major depressive disorder in adults and adolescents. Escitalopram tablet dosage ranges from 5 mg to 20 mg daily.

• Fluoxetine (Prozac): Fluoxetine is a medication commonly prescribed to treat bipolar disorder II for a short period of time. Dosage typically varies from 10 mg to 60 mg daily. Fluoxetine dosages may change based on the condition being treated.

• Fluvoxamine (Luvox): Fluvoxamine treats major depressive disorder and OCD symptoms. The recommended dosage for fluvoxamine starts at 50 mg daily. A maximum of 150 mg can be prescribed.

• Paroxetine (Paxil): FDA-approved for adults with major depressive disorder, OCD, and premenstrual dysphoric disorder (PMDD). The recommended dosage for paroxetine is 20 to 50 mg daily.

• Bupropion (Wellbutrin): Wellbutrin helps to treat symptoms of major depressive disorder. Dosage is often increased over time. The typical dosage for bupropion is between 200 and 450 mg a day.

A healthcare provider may prescribe other types of antidepressants, like tricyclic antidepressants or monoamine oxidase inhibitors, as part of your treatment plan. However, these types of antidepressants have an increased risk of side effects.

What are the side effects of antidepressants?

SSRI side effects vary but may include the following:

• Headaches

• Dry mouth

• Insomnia

• Nausea

• Fatigue

• Low libido

Adolescents and young adults may have an increased risk of suicidal ideation while taking antidepressants. Be sure to reach out to your healthcare provider for help if you experience thoughts of self-harm.

What Other Treatment Options Exist for Bipolar Disorder?

A healthcare provider may recommend psychotherapy along with medication. Psychotherapy can have several benefits, including helping those with bipolar disorder take their medications regularly. Meeting with a mental health professional can help give those with bipolar disorder communication tools and methods for managing thoughts and emotions. 

If you have bipolar disorder, consider taking steps in your daily life to maintain a healthy routine of adequate sleep, healthy eating, and regular exercise to stay healthy. Health experts have found that those who engage in a healthy lifestyle are more likely to be consistent with medications and feel better overall.

How Do You Choose the Right Medication for Bipolar Disorder?

Don't feel discouraged if it takes a while to find an ideal treatment plan, there’s no one-size-fits-all when it comes to bipolar disorder treatment. A healthcare provider can help you find the best treatment plan for you by learning more about your needs. To determine the best treatment plan for you, a healthcare provider may ask about current symptoms, your overall health status, age, and other factors that may affect medication effectiveness.

Where Can I Learn More About Treating Bipolar Disorder?

Bipolar disorder is too often an isolating experience for those with the condition. At LifeMD, a licensed healthcare provider can work with you to help manage bipolar disorder in your daily life. 

LifeMD works with insurance plans that cover mental health services for at least 95% of our patients. Still, there are tips and alternative options for care for people without health insurance. You don’t have to figure out how to live with bipolar disorder or any other mental health challenges alone.

Get started today by exploring diverse options for bipolar disorder treatment.

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