How many medicines should I be taking for my symptoms of bipolar mood disorder?
There are no easy answers to this and it is a very individual choice. Generally one medicine should always be the aim but combinations (often called “polypharmacy”) sometimes help. It is rarely of any use to combine drugs with similar ways of working. Below are some of the combinations that are used with the reasons. This is not a complete list but you might want to talk to your prescriber about any combinations not on this list you may be prescribed.
Generally the aim is one drug to help prevent you becoming ill again. However, this can be difficult to do in bipolar disorder and many people need to take two (or more) to prevent a relapse. Some combinations of medicines have a logic and possible advantages. It will be an individual's decision. Finding a drug that stops both highs AND lows is difficult, and so one to help stop highs and one to stop lows may be the best option.
| Main medicine | Second medicine | Reason |
|
Olanzapine, risperidone or quetiapine |
Lithium, carbamazepine or valproate |
May be a more effective combination |
|
Lithium |
Lamotrigine |
May be a more effective combination than lithum or lamotrigine by themselves (van der Loos 2010) |
|
Lithium |
Valproate |
May be a more effective combination than valproate by itself (Geddes 2010) |
|
Lithium |
Carbamazepine |
May be a more effective combination |
|
Valproate |
Lamotrigine |
May be a more effective combination |
|
Antidepressants |
Lithium, carbamazepine or valproate |
To reduce the chance of the antidepressant switching from depression to mania in bipolar depression |
|
Lamotrigine |
Antidepressants |
Antidepressants to get depression better and lamotrigine to prevent it returning |
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