Bipolar, Not So Much by Chris Aiken

Author:Chris Aiken
Language: eng
Format: epub
Publisher: W. W. Norton & Company
Published: 2016-03-05T16:00:00+00:00

OTHER MOOD DESTABILIZERS

The key to treating bipolar is to stay clear from things that can destabilize mood. This is particularly true for rapid cycling, mixed states, and mania. Antidepressants are not the only mood destabilizers. In the previous section you learned about a host of lifestyle factors that can destabilize mood, most importantly irregular sleep problems and drugs of abuse.

Besides antidepressants, the two most important medications that can destabilize mood are stimulants and steroids (Yildiz et al., 2015). Stimulants are used to treat ADHD and include versions of amphetamine (Adderall, Dexedrine, Vyvanse) and methylphenidate (Ritalin, Concerta, Focalin). Chapter 22 looks at safer ways to treat ADHD in bipolar disorder.

Steroids are often prescribed for asthma, arthritis, allergic reactions, and inflammation. Examples include prednisone, dexamethasone, hydrocortisone, and prednisolone. They usually don’t cause problems in the form of a skin cream or inhaler, but when taken orally, they can cause aggression and manic symptoms, even in people without bipolar.

There are other medicines that may destabilize mood, but the risk is either very low or unproven. These include a few that may be used treat bipolar depression: modafinil (Provigil), armodafinil (Nuvigil), pramipexole (Mirapex), and thyroid hormone. Others in this group include: naltrexone, varenicline (Chantix), testosterone, anticholinergics, ketamine, cyclobenzaprine, and non-steroidal pain medicines (NSAIDs) (Yildiz et al., 2015).

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