The current standard treatment for Bipolar Disorder is a combination of drugs and psychological counseling. Drug treatment can be absolutely critical during a bipolar medical crisis, but long-term use of many medications currently approved for use in treating Bipolar Disorder carries a significant health risk. The risk is due in part to the fact that long-term use of these medications has not been studied adequately, but also because these drugs have unpleasant and sometimes dangerous side effects. In fact, medicating Bipolar Disorder can become an exercise in managing side effects as much as it is a trial-and-error exercise in managing symptoms. SSRI (Selective Serotonin Reuptake Inhibitor) drugs serve as an excellent example of the danger of using drugs long-term to treat bipolar illness. Nobody knows what long-term detrimental effects the use of these drugs may have on the brain. Current studies that I have seen on the subject indicate definite cause for concern.
My own personal experience with drug therapy has not been positive. My life and my health - both mental and physical - took a dramatic and wonderful turn for the better in 2002 when I switched from a chemical approach to managing my illness to a much more natural approach. Over the last two years, I have had great success controlling the symptoms of my bipolar illness with diet and moderate exercise. I wish that I had known six years ago what I know now! When I was diagnosed in early 1998, I was promptly put on my first “cocktail” of drugs while I was in the hospital. At the time, needless to say, I was very ill. I was deeply depressed, I had serious self-esteem issues, I was very emotionally immature for my age, and I was basically non-functional. My ability to handle stress was virtually nonexistent. I was so ill that I could not hold a job for any length of time. I believe now that I have been bipolar since childhood, and that knowledge explains a lot of my behavioral problems and my inability to build a stable and successful life as an adult. I self-medicated my illness with recreational drugs and alcohol for years, but the episode of mania that led to the proper diagnosis of my illness was my first major bipolar crisis. The episode of mania had been preceded by months of ever-worsening depression. To make a long story short, when the manic phase hit, I sold all of my Dell stock ($2100 worth!) and spent it all in one day on expensive electronic and computer equipment that I wanted. I had my “dream” list of stuff, and I went out and bought as much of it as I could with that wad of cash! I had a great time that day, despite the fact that I was impatient and very irritable because I was so manic. Of course, the inevitable crash came and I ended up in the hospital. Drug therapy worked for a while, but none of the “cocktails” I was put on ever worked very well. I remained very ill over the next four years with my bipolar symptoms under varying degrees of control.
There are several drugs currently used to control the various symptoms of Bipolar Disorder. Among those are Lithobid, Depakote, Lamictal, Effexor XR, Paxil, Wellbutrin, Neurontin, Xanax, BuSpar, Klonopin, Ativan, Valium, Tegretol, Risperdal, and Zyprexa. I would like to share my personal experience with each drug in this list as well as discuss the side effects those taking each drug may experience. It can be hard to isolate which side effect came from which drug with certainty since side effects do tend to have some overlap and I am relying on my own memory from a time when I was much more ill than I am now, but I am making every effort to relate my experience accurately and without unnecessary emotionalism or bias about what was for me a few years of living hell in a constantly medicated state with little real progress made in terms of the restoration of my mental health and a return to a relatively normal functional adult status. I strongly encourage my readers to take the time to visit the provided links (and do your own research) on each drug discussed below and consider whether you would feel comfortable taking these drugs or with having a loved one on them on a long-term basis given the side effects of the drugs and the safety issues associated with their long-term use.
Lithobid (lithium carbonate) is a prescription form of lithium. Lithium has been used successfully to treat the manic phase of bipolar illness since the 1950’s. It is, however, a very toxic drug that has a very narrow therapeutic dosage range. Blood levels of lithium must be checked regularly in order to adjust medication levels to achieve therapeutic dosage and in order to avoid lithium toxicity, which is dangerous and can be lethal. Lithium’s side effects include (courtesy of http://www.medicinenet.com/lithium/page2.htm) “fine hand tremor, dry mouth, altered taste perception, weight gain, increased thirst, increased frequency of urination, mild nausea or vomiting, impotence, decreased libido, diarrhea, and kidney abnormalities. Many of the gastrointestinal side effects (nausea, taste alterations, diarrhea) often disappear with continued therapy. Additionally, they may be less common if lithium is taken in divided doses with meals. If diarrhea or excessive urination lead to dehydration, lithium toxicity is possible. Lithium can also cause changes in the electrocardiogram, low blood pressure, and decreased heart rate.” Of those, I recall experiencing dry mouth, the altered taste perception, weight gain, increased thirst, increased frequency of urination, and mild nausea. I often felt lethargic, had trouble thinking clearly, and I experienced occasional clumsiness. My emotions also felt “flat” like I had turned into a zombie emotionally. But, the most intolerable side effect I experienced was nausea. I lived in Texas at the time, and although I drank water constantly during the hot summers there, I still experienced extreme nausea on a fairly regular basis. I still vividly remember becoming ill while driving into Houston to work one day in 2001. I thought I had gotten some bad food at a convenience store, but I later realized that it was the Lithobid making me so nauseated. If it had been the food, I would have vomited. As it was, I just stood over a convenience store commode wishing that I could vomit. I wasn’t suicidal at all at the time, but I remember thinking that I would rather die than continue to endure such extreme nausea for even another moment.
Depakote (divalproex sodium) is an anticonvulsant drug that has been approved for use as a mood stabilizer. It did work to stabilize my moods at least to some degree, but it also left me feeling very drugged and lethargic. Depakote has many side effects. A lengthy discussion of those can be found here. The main side effects that I recall experiencing were emotional “flatness”, fatigue, and generally feeling very drugged. Depakote was my drug of choice for two very nearly successful suicide attempts in 1998. If I had taken just a few more pills either time, I would not have survived. This drug is very toxic to the liver, so I consider myself very blessed to still have a healthy, fully functional liver after having experienced two nearly fatal overdoses.
Lamictal (lamotrigine) is an anticonvulsant drug that has been approved for use as a mood stabilizer. It can be difficult to begin treatment with this medication because it can cause a potentially dangerous rash, a side-effect that has reportedly proven fatal to a few patients. In my opinion, one fatality is one too many and should be sufficient reason to remove the drug from the market. From a personal perspective, I don’t have much to share in the way of experience concerning this medication. My doctor prescribed this drug for me and wanted me to try it, but I did not take it for very long. My doctor warned me about the possibility of developing a potentially dangerous rash, and he did a good job of scaring me away from this medication.
Effexor XR (venlafaxine) is an SSRI antidepressant medication. It is the antidepressant that I had the most success with. Effexor XR did provide significant relief from depression, but it also caused stomach upset and nausea severe enough that I had to discontinue using it. Like several other drugs used in the treatment of Bipolar Disorder, Effexor XR has been associated with unpleasant side effects, a very unpleasant withdrawal syndrome that has been described by some patients as “horrific”, and Wyeth-Ayerst Laboratories, the manufacturer of the drug, may be facing a lawsuit. A petition calling for a lawsuit against them does currently exist. I strongly urge those who have had negative experiences with this drug to sign the petition. I have done so. In addition, Effexor XR , along with other SSRI medications, has been associated with an increased risk for suicide in children.
Paxil (paroxetine) is an SSRI antidepressant medication. I took it for a couple of years, but with marginal positive results. The main side effect I noticed with this medication was the sexual side effects. It did very little to alleviate depression. I do not believe that Paxil is an effective medication for treating Bipolar Disorder. As with other SSRI medications, Paxil has been associated with violent and suicidal behavior and its manufacturer has been sued. The results of three interesting studies on Paxil can be found here. Paxil has many side effects. A lengthy discussion of them can be found here. Please click here to access several truly frightening stories relating experiences with Paxil.
Wellbutrin (bupropion) is an antidepressant medication that has also proven effective as a smoking cessation aid. Side effects include anxiety, insomnia, dry mouth, constipation, nausea, vomiting, headache, and tremor. I was on this medication briefly, but long enough to notice that it reduced my desire to smoke. I found that very surprising since at the time I had no conscious desire to stop smoking. I mentioned that fact to my doctor, and he told me that bupropion was being tested as a smoking cessation aid (this was in 1998). Bupropion for use as a smoking cessation aid is currently marketed as Zyban. I stopped taking it due to issues with anxiety, insomnia, and “racing thoughts”. I am aware that physicians are currently very hesitant to prescribe antidepressants for bipolar patients because of the risk of precipitating a manic episode, but this is the only antidepressant that I was on that actually had that effect on me.
Neurontin (gabapentin) is an anticonvulsant used in the treatment of Bipolar Disorder. It is, however, not approved for the treatment of bipolar illness, and is in fact a useless drug in terms of treating the illness. It is far from being a harmless drug, though. Neurontin causes a condition called tardive dyskinesia, a neurological syndrome caused by long-term use of neuroleptic drugs. The manufacturers of Neurontin, Pfizer, Inc., have been found criminally liable for illegally promoting the off-label use of the drug. The following is quoted from: http://www.adrugrecall.com/neurontin/effects.html:
“Neurontin entered the U.S. market in February 1994 as a powerful epilepsy drug. From mid 1995 to 2001, Neurontin experienced remarkable growth of off-label sales, a practice that has been beneficial over the years in sparking medical innovations. While a common practice, the risks of doing so are becoming more scrutinized. Pfizer Inc. has just pleaded guilty to a two count criminal information charging the company with violating the FDA with misbranding Neurontin. The company has been sentenced to pay a $240 million criminal fine, amounting to the second largest criminal fine in a health care fraud prosecution.
Pfizer ’s ability to implement a coordinated national effort for an off-label marketing plan has misled the medical community and may have greatly impacted the number of adverse effects suffered by Neurontin patients receiving the prescription based off of false claims. The “illegal and fraudulent promotion scheme” has been putting Neurontin patients at risks for dangerous Neurontin side effects. It has been estimated that 90 percent of Neurontin’s $2.7 billion in sales during the first year was because of off-label uses.”
Pfizer, Inc. fraudulently promoted neurontin for eleven off-label uses. This information concerning its use for the treatment of bipolar illness is quoted from http://www.citizen.org/eletter/articles/neurontin.htm:
Psychiatrists were told that early results from trials evaluating gabapentin in the treatment of bipolar disorder indicated a 90 percent response rate when the drug was started at 900 milligrams per day and increased to 4,800 milligrams per day. No such results existed. In fact, the only type of clinical trial being conducted at the time was a pilot study. According to the court documents, Parke-Davis was in possession of clinical data indicating that increasing the dose did not increase gabapentin’s effect. The FDA-approved dosage for gabapentin in adults is 900 to 1,800 milligrams per day.
Any data regarding gabapentin in bipolar disorder was anecdotal and of unclear scientific value. Most of the published reports on the use of gabapentin in bipolar disorder had been written and sponsored by Parke-Davis, a fact that was hidden. Medical liaisons of the company were trained to tell psychiatrists that there were no reports of adverse reactions with gabapentin when used in psychiatric illness. In fact, such reports had been given to Parke-Davis by health care professionals but the company attempted to hide this information from physicians.
It is criminal behavior such as this carried out for the sole purpose of increasing profits that has influenced my currently extremely low opinion of the pharmaceutical industry. Some people in this world lack a conscience, and unfortunately far too many of them are employed by the pharmaceutical industry. These people are playing with the health and the lives of others, and the pain, suffering, and even the deaths of their victims does not concern them at all. All that matters to such people is financial gain. They do not care how many people they hurt or in what way they hurt them if doing so will benefit their bank accounts and/or the bottom line of their corporations. Such a state of affairs may be unthinkable to decent, moral people but it is nonetheless a very unfortunate reality. I feel very fortunate not to have been on this useless but very dangerous medication for an extended period of time.
Xanax (alprazolam) is an anti-anxiety medication in the benzodiazepine family of drugs. In the months following my diagnosis, I suffered from severe bouts of anxiety, and my doctor prescribed Xanax to treat that issue. It worked very well, but unfortunately I became addicted to it and began abusing it. My doctor was not overly concerned about my addiction to this drug at that time. I believe that he felt that it was relatively harmless compared to other issues in my life that needed more immediate attention. But, I was not comfortable being addicted to a drug, and in light of previous substance abuse problems, I was scared by the fact that I was abusing the Xanax more and more frequently, not just to relieve anxiety but to enjoy the brief but intense high that I got from taking up to 4mg of the drug at one time. Against my doctor’s advice, I entered the hospital to deal with my addiction. I am here to tell you that withdrawal from Xanax is extremely difficult! I quit cold turkey, and for several days I was not a very pleasant person to be around. I beat the addiction though, and I have not touched Xanax since that time, nor do I have any intention of ever doing so again. I would rather deal with my issues with anxiety without resorting to the use of addictive drugs. Please click here for more information on benzodiazepines and the withdrawal syndrome that is associated with their use.
BuSpar (buspirone HCl) is an anti-anxiety medication. I don’t have much personal experience with this medication, but I was put on it briefly in 1997 - prior to the bipolar diagnosis. I was experiencing extreme anxiety at the time. My doctor asked me to rate my anxiety level on a scale of 1 to 10 with 10 being the worst. I said 10, and I meant 10! I started the BuSpar, but I was too impatient to wait for it to start working. Unfortunately, I dealt with my anxiety problem via substance abuse, which is not an uncommon occurrence in people who suffer from Bipolar Disorder. Bristol-Myers Squibb, the manufacturer of BuSpar - along with two other pharmaceutical companies - has faced an antitrust lawsuit. BuSpar has many unpleasant side effects.
Klonopin (clonazepam) is an addictive benzodiazepine tranquilizer used to treat panic disorder and seizure disorders. I took this drug in low doses for a couple of years, but never experienced any dependence issues with it. I have to say that it did what my doctor intended it to do. He prescribed it as a sleep aid, and since it did make me drowsy it accomplished its purpose. As far as I can recall, I never experienced any bothersome side effects from this drug, but it does have many of them, which are listed here.
Ativan (lorazepam) is an addictive benzodiazepine drug used for a variety of purposes including relief of anxiety, insomnia, and controlling mania. I was given Ativan occasionally while hospitalized. I do not recall experiencing any bothersome side effects, but they do of course exist. A list of them can be found here along with general information on the drug. The most dangerous side effects of Ativan are severe respiratory failure and death. The following is quoted from http://www.adrugrecall.com/ativan/ativan.html:
“Ativan is a benzodiazepine medication used to treat panic and anxiety disorders. Linked to side effects such as severe respiratory failure and death, Ativan can be dangerous when too much is used. Reactions to Ativan have included increased aggressiveness, exhibited by violent behavior in some instances, depression with or without suicidal thoughts or intentions, personality changes, hallucinations, depersonalization, derealization, as well as other psychotic symptoms.”
Valium (diazepam) is an addictive benzodiazepine tranquilizer used primarily to relieve anxiety. I have only been given Valium a few times in the hospital and briefly by prescription. I do not recall experiencing any adverse side effects, but those do of course exist. The side effects of Valium are listed at the bottom of this page.
Tegretol (carbamazepine) is an anticonvulsant drug which is also used to control mania. Side effects include (courtesy of http://www.mentalhealth.com/drug/p30-t01.html) “drowsiness, headache, ataxia, vertigo, fatigue, diplopia, dizziness, nausea, vomiting, allergic skin reactions, edema, fluid retention, dry mouth, leucopenia, and eosinophilia”. In 1997, I was misdiagnosed as “schizo-affective” rather than bipolar, and my doctor at the time prescribed Tegretol as a part of my treatment. The only side effect that I recall experiencing was extreme nausea, even when I took it with food. It did not cause vomiting, but the nausea was unbearable and it was the reason for discontinuing the use of this drug.
Risperdal (risperidone) is an antipsychotic drug used to treat schizophrenia and other psychotic disorders. Side effects include (courtesy of http://www.mentalhealth.com/drug/p30-r05.html) insomnia, agitation, extrapyramidal disorder, anxiety, headache, rhinitis, and weight gain (mean 2-3 kg) during long-term therapy. Rarely hypotension, syncope, cardiac arrhythmias, first degree AV-block, seizure, gynecomastia, galactorrhea, amenorrhea, menorrhagia, ejaculatory and erectile dysfunction may occur. I was on Risperdal very briefly due to the unexpected effect that it had on me. Shortly after I began taking Risperdal, I because a very aggressive, angry, raging, abusive individual who was not at all pleasant to be around. The drug caused rather dramatic major behavioral changes. Risperdal clearly is not a safe drug. Its manufacturer, Johnson & Johnson, has acknowledged that Risperdal increases the risk of stroke in elderly patients. The fact that it is being increasingly prescribed for children and for use in the treatment of illnesses/conditions other than schizophrenia (and other serious mental illnesses) is also cause for concern.
Zyprexa (olanzapine) is an antipsychotic/antimanic medication. Zyprexa is an extremely dangerous drug. Side effects include Neuroleptic Malignant Syndrome (NMS), tardive dyskinesia, orthostatic hypotension, seizures, and the potential for cognitive and motor impairment. The major side effect that I experienced from using Zyprexa was weight gain. I gained about sixty pounds while I was on this medication! My doctor did warn me about the possibility of weight gain, but not of that magnitude. Zyprexa also causes diabetes, and Eli Lilly - the manufacturer of Zyprexa and Prozac (which also causes diabetes) - is now trying to get FDA approval for its new diabetes drug. Anybody smell a scam here? Make millions of people sick, and then offer them a cure for the illness that you created. If you are thinking “this allegation is unthinkable”, I fully agree. But, it is a very real possibility. Pharmaceutical companies have been caught repeatedly engaging in illegal and/or unethical practices for the sake of profits. I, for one, would not put such a heinously cruel and evil crime past them. Yes, it is unthinkable, but it may unfortunately be reality.
I spent four very long and hellish years approaching the treatment of my bipolar illness with these drugs. I attempted to beat my illness into submission with chemicals, and of course that effort - not ever a very successful one - ultimately utterly failed. Hindsight is 20/20. If I had known in early 1998 what I know now, I could have avoided years of unnecessary suffering and I could have avoided the risks inherent in filling my body with dangerous drugs that did little to bring my illness under control or to restore my mental health. I spent four years so deeply depressed most of the time that just being awake sometimes HURT and I wanted desperately for my suffering to end. For four years, I lived every single day under a dark cloud of severe, relentless, never-ending, mind-numbing, spirit-crushing DEPRESSION. I attempted suicide several times in 1998 and once again in 2001. I thought about suicide many times over those years. I spent those years so ill that I was unable to work for any length of time. Most of my time was spent in front of my computer or watching TV. I did anything that I could - including sleeping a great deal at times - to keep my mind off of how miserable I was.
In the summer of 2002, a miracle of sorts happened. My young niece had been to see an Alternative Medicine practitioner in Houston who was able to eliminate her recurring problem with ear infections simply by eliminating offending foods. My mother suggested that I see this doctor, and I am extremely glad that I did. He diagnosed several food allergies (or sensitivities, if you prefer), and after I eliminated the offending foods from my diet I experienced a startlingly rapid return of my mental and physical health. Had I known six years ago now that regaining my health could be accomplished by simply altering my diet and getting moderate regular exercise, I could have avoided four very long and very hellish years of needless suffering! I am still affected by Bipolar Disorder. I deal with the effects of the illness on my thinking and my moods every day. The difference between then and now is that now I am in control of my bipolar illness whereas during those four years that I was trying to beat it into submission with chemicals, I remained at the mercy of my illness, too ill to have any real chance of recovering enough to begin building a “normal” life. For the most part, I consider myself pretty “normal” now. Now that my health is restored enough that I can do so, I am working on building a life that I can be proud of and I am focusing on helping others suffering from Bipolar Disorder who are where I was not all that long ago. Good health is priceless. Often we don’t realize how much we value it until we are robbed of it. Bipolar Disorder robbed me of my mental health. Well-meaning medical professionals armed with an arsenal of chemicals attempted to help me, but with little success. I am extremely grateful to the Alternative Medicine practitioner who did in weeks what all of those doctors armed with all of those drugs could not even come close to accomplishing in four years. The man gave me my life back and made possible a truly miraculous recovery from an illness that causes tremendous suffering in not only those afflicted with it but in their loved ones as well. Expensive, dangerous drugs are not the best answer to managing bipolar illness long-term. Moderate exercise and a diet free of offending foods which cause/exacerbate bipolar symptoms is a far superior and much more natural way to manage this illness and restore those suffering from it to health and functionality than is attempting to beat it into submission with chemicals.