Experimental Bipolar Treatment: Are They Safe and Effective? - PsychCentral.com

Bipolar disorder treatment options continue to improve as researchers develop a better understanding of the condition and find new ways to treat it.

It can take trial and error to find the right treatment for bipolar disorder. It can be frustrating as you try new methods only to discover you are not noticing any differences or that you cannot stand the side effects of the medication.

New treatments for bipolar disorder may help improve the effectiveness of treatments and decrease the risk of side effects. New forms of treatment undergo considerable testing to check for safety, effectiveness, and common side effects.

As new therapies get approved for use with bipolar disorder, your doctor will gain more tools for helping you achieve your treatment goals.

Researchers continually look into new treatments for bipolar disorder.

You can find hundreds of recruiting and ongoing clinical trials when searching for bipolar disorder on ClinicalTrials.gov, which means experts continue to look for new insights into the condition and new treatment options.

New bipolar medicine

One of the most recent medications for treating bipolar I and II disorder is lumateperone (Caplyta). The Food and Drug Administration (FDA) first approved the medication in 2019 to treat depressive episodes associated with bipolar disorder.

Lumateperone is an atypical antipsychotic. Though generally well tolerated, you may experience increased suicidal thoughts or actions as well as weight gain and changes in blood sugar levels.

Can bipolar disorder be treated without medication?

When treating bipolar disorder, doctors may recommend additional treatment options beyond medications. In fact, for many, combination of therapies with medication may work best.

Some additional therapies include:

• transcranial magnetic stimulation — a noninvasive therapy that uses magnets to change the electrical signals in different parts of the brain
• electroconvulsive therapy — done under general anesthesia, a doctor uses electric pulses on the brain and is recommended when other treatments have not been effective

Talk therapy is another option you may want to consider for treating bipolar disorder. There are several different options you can choose from, including:

• group psychoeducation — often includes a therapist along with several other people with bipolar disorder
• cognitive behavioral therapy — helps change thought and behavior patterns
• interpersonal and social rhythm therapy – a therapist helps to regulate daily routines and sleep patterns to help regulate mood
• family-focused therapy — includes family members in therapy to help the family dynamic
• dialectical behavior therapy — a single or group therapy approach that helps to teach mindfulness and acceptance skills

The most effective treatment for bipolar is what works for you. No single treatment, including medications, electroconvulsive therapy, and psychotherapy, is 100% effective in treating bipolar disorder for everyone.

Additionally, what is most effective now may not be your best option down the road, as treatment options continue to improve. For example, second-generation antipsychotics provide effective treatment with less severe side effects in many cases.

In general, however people with bipolar disorder find the most success with a combination of medication and psychotherapy.

The best way to determine the ideal treatment plan for you is to consult with a doctor.

Anticonvulsants

Anticonvulsants, also known as mood stabilizers, can help treat bipolar symptoms. Doctors often recommend them for the treatment of bipolar disorder. Both valproic acid and carbamazepine have FDA approval for use in preventing and treating mania.

Some common side effects of anticonvulsants include:

• drowsiness
• weight gain
• dizziness

In more severe cases, they can cause serious side effects, such as issues with the liver, blood problems, or skin issues.

Lithium

Lithium is a common and effective way for doctors to treat bipolar disorder. It can help prevent both highs and lows and is safe to use for long-term prevention of bipolar depression and relapse.

While taking lithium, your doctor will need to monitor your kidneys and thyroid. Some common side effects can also include:

• dry mouth
• issues with digestion
• restlessness

Second-Generation Antipsychotics (SGAs)

A common medication for the treatment of mania or depressive episodes is second-generation antipsychotics (SGAs) with other medications, such as mood stabilizers.

Currently, the FDA has only approved quetiapine (Seroquel) and the combination of olanzapine (Zyprexa) and fluoxetine to treat bipolar disorder.

While generally safe, SGAs can cause side effects such as:

• high cholesterol
• weight gain
• high blood sugar
• high blood pressure

Standard Antidepressants

Antidepressants may not be the best option for you or others. Experts have found that for some people, antidepressants cause mania in some people. You should discuss the potential for side effects with your doctor before taking them and let your doctor know if they trigger mania.

Researchers continually look into what causes bipolar disorder and treatments that may work better than current options.

Experts still don't know the exact cause of bipolar disorder, but they suspect a genetic component, along with differences in brain function and structure. By learning more about the cause, researchers may find more effective treatment options.

Understanding how genes play a role in bipolar disorder may help researchers find new treatment methods in the future. In a 2020 study, researchers looked for gene receptors in people who have bipolar disorder. They have identified several receptors that medications may be able to target to provide effective therapy for the condition.

Another application of genetic understanding comes from predicting who may or may not respond well to current treatment options. According to a 2021 meta-analysis, researchers investigated how genetics may affect both the effectiveness and the potential for side effects of lithium in people with bipolar disorder.

While they recognized the potential for better treatment with genetic understanding, they also noted that few studies involving genes and potential therapies provided quality results. They recommended that new research should improve on previous study designs and continue to look for adequate biomarkers associated with bipolar disorder.

Treatment options for bipolar disorder continue to improve. Researchers are continually studying how this mental health condition works and ways to provide more effective treatment.

Currently, you have several options to choose from, including medications and various forms of therapy. You will likely find that a combination of medications and other therapies will work best. Still, no therapy works perfectly for everyone, so you should consider working closely with your doctor to find the best treatment option for you.

If you are interested in joining a clinical trial, you may want to talk with your doctor. You could also search for bipolar-related studies on ClinicalTrials.gov to find ones in your area.

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