Weston Psychiatrist on Bipolar Disorder Treatment & Polypharmacy

Weston residents managing bipolar disorder may be prescribed more than one medication, a practice known as polypharmacy. Psychiatrist Edward Kilbane, MD, explains this approach tailors treatment to the condition's complex and varied symptoms, rather than indicating a more severe illness.

Bipolar disorder involves both depressive and manic or hypomanic episodes, each requiring different therapeutic strategies. Some medications target mania, others bipolar depression, and some aid in long-term mood maintenance. Roughly one-third of individuals with bipolar disorder use more than three medications for effective symptom management.

Treatment often starts with a mood stabilizer, such as lithium or an antiseizure medication, for long-term mood swing management. If symptoms persist or include psychosis, an atypical antipsychotic may supplement treatment for acute manic or depressive episodes. This layered approach helps healthcare providers address the disorder's diverse manifestations.

Multiple medications are common for individuals with a history of severe depression, suicidal ideation, or psychosis. Kilbane notes bipolar disorder carries the highest suicide risk among mood disorders, with lithium proving beneficial for suicidal thoughts. Combining medications can also mitigate side effects, with providers sometimes adding new drugs to lessen adverse reactions from existing treatments.

Beyond bipolar disorder, many individuals also manage co-occurring conditions like anxiety disorders, substance use disorder, or ADHD, which may necessitate additional medications. Kilbane emphasizes that medication is one part of a comprehensive treatment plan, which also includes psychotherapy and lifestyle adjustments such as consistent routines and adequate sleep. Patients should maintain open communication with their healthcare providers about treatment plans, symptom changes, or side effects.