Mental health
Medicines for Bipolar disorder
A long-term mood condition with episodes of mania or hypomania and depression — managed with mood-stabilising medicines, careful monitoring, and a strong focus on preventing relapse.
Education and reference only. This explains which medicines are used and why, in plain language — it deliberately contains no doses and is not a substitute for advice from your doctor or pharmacist. Always discuss your own treatment with a qualified clinician, and check the BNF and the product labelling for prescribing detail.
Quick answer
What is Bipolar disorder?
Bipolar disorder is a long-term condition in which mood swings between two extremes. In a "high", or mania, a person may feel elated, full of energy, need little sleep, talk and think fast, and act impulsively in ways that can cause harm; a milder version is called hypomania.
- How it is treated: The central aim is to stabilise mood during episodes and, crucially, to prevent future ones.
- Self-care: A regular sleep and daily routine, avoiding alcohol and street drugs, managing stress, and learning to recognise early warning signs of a high or a low all help keep mood stable and prevent relapse.
- When to seek help: If you notice early signs of a high or a low, or your usual treatment is not holding, contact your mental-health team or GP promptly — early action can prevent a full episode.
What it is
Bipolar disorder is a long-term condition in which mood swings between two extremes. In a "high", or mania, a person may feel elated, full of energy, need little sleep, talk and think fast, and act impulsively in ways that can cause harm; a milder version is called hypomania. In a "low", they experience the symptoms of depression — persistent low mood, loss of interest, and low energy. Between episodes, many people feel well. The pattern, severity and triggers vary from person to person, and episodes can be disruptive to relationships, work and safety. With the right long-term treatment and support, most people can manage the condition well and stay stable for long periods.
How it is treated
The central aim is to stabilise mood during episodes and, crucially, to prevent future ones. Mood-stabilising medicines are the foundation. Lithium is highly effective at reducing relapse and also lowers the risk of suicide, but it has a narrow safe range and needs regular blood tests to check its level and to monitor the kidneys and thyroid. Antipsychotics are used for acute mania and for ongoing maintenance, and lamotrigine is used mainly to prevent the depressive episodes. Antidepressants are used cautiously and rarely alone, because they can tip a person into mania. Sodium valproate is another mood stabiliser, but it must not be used in anyone able to become pregnant unless stringent pregnancy-prevention conditions are met, because it can cause serious harm to an unborn baby. Treatment is combined with psychological support, education to spot early warning signs, and a clear relapse-prevention plan.
For this condition, these medicines
Medicine classes used for Bipolar disorder
Each links to a full, dose-free guide — what it is, how it works, who can and cannot use it, side effects, interactions and FAQs.
Symptom checker
Symptoms that can point to Bipolar disorder
Bipolar disorder can be one cause of these symptoms. Each guide explains the other possible causes and the red-flag warning signs that mean you should get urgent help:
By active ingredient
Specific medicines used for Bipolar disorder
Dose-free guides to individual active ingredients used in bipolar disorder — what each is, how it works, how to take it, and its advantages and disadvantages:
Beyond medication
Lifestyle and self-care
A regular sleep and daily routine, avoiding alcohol and street drugs, managing stress, and learning to recognise early warning signs of a high or a low all help keep mood stable and prevent relapse.
When to get help
When to see a doctor
If you notice early signs of a high or a low, or your usual treatment is not holding, contact your mental-health team or GP promptly — early action can prevent a full episode. During a manic or severe depressive episode a person may be at risk; if there are thoughts of suicide, call the Samaritans on 116 123 or 111, and if someone is in immediate danger, call 999.
Not sure how urgent it is? It is always OK to call NHS 111 for advice, day or night.
Answers
Bipolar disorder: frequently asked questions
What medicines are used for bipolar disorder?
Mood stabilisers are the foundation. Lithium reduces relapse and lowers suicide risk but needs regular blood tests; antipsychotics are used for acute mania and maintenance; and lamotrigine mainly helps prevent the depressive episodes. Sodium valproate is another option but must not be used in anyone able to become pregnant unless strict conditions are met. The right combination depends on your pattern of episodes.
Why does lithium need blood tests?
Lithium is very effective, but the gap between a helpful level and one that causes harm is narrow, so blood tests check that the level is right. Tests also keep an eye on the kidneys and thyroid, which lithium can affect over time. If you develop symptoms such as marked thirst, vomiting, diarrhoea, tremor, drowsiness or confusion, seek advice promptly, as these can be signs the level is too high.
Why can't valproate be used in people who can become pregnant?
Sodium valproate can cause serious birth defects and developmental problems if taken in pregnancy. Because of this it must not be used in anyone able to become pregnant unless a stringent pregnancy-prevention programme is in place and the strict conditions are met. If this applies to you, your specialist will discuss safer alternatives.
Can I take an antidepressant for the low phases?
Antidepressants are used cautiously in bipolar disorder and usually not on their own, because they can trigger a swing into mania. The depressive episodes are more often treated with mood stabilisers such as lamotrigine or certain antipsychotics. Any antidepressant is started carefully under specialist guidance.
Keep reading
Related articles
Sources
Where this is drawn from
- NICE CG185: Bipolar disorder: assessment and management.
- NICE CKS: Bipolar disorder.
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