I am 29 and have bipolar. Which medicines are effective?

Question

Hello doctor,

I am a 29-year-old woman diagnosed with bipolar disorder five years ago. I was on Lithium earlier, but stopped due to weight gain and thyroid issues. Currently, I am again experiencing low mood, lack of energy, and difficulty focusing on work. At times, I also have short phases of overactivity. My TSH (thryoid-stimulating hormone) is slightly high. The doctor is considering starting Lamotrigine or Quetiapine. I am worried about long-term medications.

Do they always cause sleepiness?
Can therapy alone be sufficient, or are lifelong medications necessary?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

Given your history of bipolar disorder with both depressive symptoms (low mood, loss of energy, poor focus) and short phases of overactivity, treatment with medication is usually recommended because therapy alone is often not enough to prevent relapses in bipolar disorder.

Lithium is very effective, but as you experienced, it can sometimes cause side effects such as weight gain and thyroid problems. Other options your doctor mentioned, such as Lamotrigine and Quetiapine, are commonly used mood stabilizers. Lamotrigine is generally better tolerated and especially effective for the depressive phase of bipolar disorder, while Quetiapine can help with both depression and mania but may sometimes cause sedation and weight gain. Not everyone becomes sleepy on these medications, and the dose can be adjusted to balance benefits and side effects.

Therapy, such as cognitive behavioral therapy (CBT) or interpersonal and social rhythm therapy, can be beneficial alongside medication by teaching coping strategies, improving daily routines, and reducing stress-related relapses.

In most cases of bipolar disorder, long-term medication is advised, even if symptoms improve, because the condition tends to recur without ongoing treatment. The exact medicine and dose can be individualized to minimize side effects while stabilizing your mood.

It is understandable to be concerned about lifelong treatment, but staying on the proper medication can prevent future severe mood episodes, protect your work and relationships, and reduce the risk of complications.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.