Bipolar disorder is a long-term illness that most often requires management throughout a person’s life. Medication is the primary form of treatment to help control moods and to decrease the highs and the lows associated with mood swings. Every person is different and sometimes people need a trial of several medications before they find a drug, or combination of drugs, that is best for them.

Medications used to treat bipolar disorder generally fall into four different categories: mood stabilizers, antidepressants, antipsychotics and anti-anxiety medications.

• Mood stabilizers: Most people with bipolar disorder are treated with medications called mood stabilizers (e.g., lithium, divalproex or valproic acid, carbamazepine). These medications provide relief from current episodes and prevent future episodes. Combination therapy with two mood stabilizers is sometimes recommended for people who do not respond to or develop resistance to the use of one medication.

• Antidepressants: These medications treat the symptoms of depression, and they work by altering the levels of certain chemicals in the brain in a way that elevates a person's mood. For people with bipolar disorder, antidepressants must be used together with a mood stabilizer medication to prevent cycling into a manic episode.

• Antipsychotics: New generation antipsychotics (e.g., olanzapine, risperidone, quetiapine) are used to help with the symptoms of mania, and they are believed to work by regulating the activity of certain brain chemicals to stabilize mood. They are also prescribed as supplements to mood stabilizers. They can help to control hallucinations and delusions in severe mania or psychotic depression. Several types of antipsychotics are available - each slightly differs in how they work, and each has their specific side effects.

• Anti-anxiety medications can help to calm or sedate a person and offer relatively quick relief from disturbing symptoms. They are sometimes used in addition to mood stabilizers. They help treat the symptoms of irritability, over-activity and insomnia.

The number of medications the most people need to manage bipolar disorder varies greatly based on the symptoms, response and individual variations. Medications must be customized to fit the individual because the patterns and severity of bipolar disorder vary from one person to person. The medications generally needed for bipolar include at least a mood stabilizer or combination of mood stabilizers along with antipsychotics, anti-anxiety drugs, and antidepressants. The total number of medications can vary from one medication to a combination of 4-6 medications.