How many medicines should I be taking for my symptoms of mania or hypomania?
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.
In bipolar mania, combinations of different types of medicine are usually best until the person settles. A mood stabiliser and an antimanic are much better than one by itself, and shorten the time until the person is well again.
| Main medicine | Second medicine | Reason |
|
Dopamine-blocking medicines such as risperidone, olanzapine, quetiapine or asenapine |
Benzodiazepine and/or hypnotic |
Quicker and more effective in the short-term |
|
Lithium, carbamazepine or valproate |
Benzodiazepine and/or hypnotic |
Quicker and more effective in the short-term |
|
Dopamine-blocking medicines such as risperidone, olanzapine, quetiapine or asenapine |
Lithium, carbamazepine or valproate |
Probably better and may allow lower doses of the dopamine-blocking medicine |