The most common reasons for patients to ask their doctors for a change of drug or dose (or request to stop taking their drugs altogether) include:

• Fear of taking medications for life

• Not wanting to be dependent on their medication

• Missing their mania, or "highs"

• The belief that “I'm better now, I don't need medication anymore”

• Dislike medication controlling their mood

• Dislike feeling chronically ill because of their reliance on medications

• Most common of all—frustration with the negative side effects of the medications used to treat bipolar

Sometimes, patients wonder what’s worse—the depression and mania, or the side effects from the medications used to control the depression and mania. In fact, one of the main reasons that people with bipolar disorder stop taking their medications is because they simply can no longer tolerate the negative side effects. The most common side effects experienced by bipolar patient’s necessitating change of the dose or medications include:

Weight Gain: Virtually any of the medications used to treat bipolar affective disorder can cause patients to gain weight, though some are worse than others. Strategies to manage weight gain include reducing calorie intake, restricting carbohydrates and regular exercise. Simply eliminating sugary foods can reduce the mid-morning or late-morning hunger that can contribute to weight gain.

Sexual Side Effects: This side effect is an important reason patients stop taking medications. Patients would not volunteer information unless asked specifically about sexual side effects.

Tremor: A tremor can also occur with a number of medications including lithium, other mood stabilizers, antipsychotics and some antidepressants. If dose reductions are either not possible or don't work, drugs such as Propranolol or atenolol can be used at low doses to treat the problem.

Sedation: Sedation can occur with most of the mood stabilizers and antipsychotics. Taking medications early in the evening and avoiding medications in mornings is usually helpful.

Gastrointestinal Side Effects: Taking your medication with or after food can reduce side-effects due to gastrointestinal irritation, such as nausea, vomiting, and diarrhea.

Skin Rashes: Rashes can occur with most medication. Usually there are very mild and trivial, but rarely they can be part of a more serious illness.

Blurred Vision: Blurry vision mostly occurs with older antipsychotics which are not used much these days.

Dizziness: A dizzy feeling can occur with a variety of medications.

Cognitive Side Effects: Many medications can produce some impairment in memory and difficulty concentrating.

The best way to minimize or avoid these side effects is to talk to your doctor immediately after noticing any of them so that necessary measures can be taken.