Bipolar Beat

Do I Have to Take Medicine Forever?

By Candida Fink MD
October 31, 2008

People who take medications to treat most serious medical conditions, including diabetes, high blood pressure, and thyroid disorders usually never question the need to be on long-term medication. Many people with bipolar disorder, however, constantly wonder whether they really need to continue taking medication to keep symptoms in check.

For a large majority of people with bipolar disorder, remaining on a preventive dosage of a mood stabilizer indefinitely is strongly recommended for the following reasons:

  • A mood stabilizer can prevent future manic episodes.
  • By preventing serious episodes, the mood stabilizer reduces the kindling effect – the tendency for mood episodes to become more serious and more frequent with each episode.
  • A mood stabilizer may provide some protection against the possibility of anti-depressant-induced mania.
  • Lithium and perhaps other mood stabilizers may help reduce the risk of suicide. (Lithium is the only mood stabilizer clinically proven to reduce the risk of suicide.)

Does this mean that everyone who’s been diagnosed bipolar has to remain on a mood stabilizer and perhaps other medications for their entire lives? Not necessarily:

  • People can be misdiagnosed. How often this occurs, nobody really knows.
  • Brains change. Over time, a brain may “grow out of bipolar” or at least become less vulnerable to severe mood swings. In addition, a person’s life may become less stressful over time – perhaps requiring less medicinal protection.
  • People who have “lighter” forms of bipolar disorder may find that they’re able to manage their symptoms without medications – for example, with psychotherapy, family therapy, lifestyle changes, nutrition, and/or other forms of therapy.

So, to answer the question posed in the title of this article, “Go Off Your Bipolar Medications?” I recommend the following:

  • If you have a severe form of bipolar, often accompanied with psychotic symptoms that have resulted in multiple hospitalizations and have a history of suicidal thoughts and behaviors, a combination of medication and psychotherapy is essential.
  • If you and your doctor question a previous diagnosis, a trial off medication may be useful, as long as your doctor carefully monitors the situation. (You may go off your meds and “feel great” when experiencing mania, so you need to keep in touch with your doctor to obtain an objective evaluation of how you’re really doing.)
  • If no medication or combination of medications seems to be helping, then trying different treatments and therapies may be the only solution.

As much as I would like to tell you that simply changing your diet will cure you – perhaps eating more fish high in Omega 3 or taking nutritional supplements – most people, especially those who have the most severe forms of bipolar disorder, respond best to the traditional treatments – a combination of medicine and therapy. (For more about alternative treatments for bipolar, check out “Alternative and Complementary Treatments for Bipolar Disorder.”)

Caution: Never stop taking your medications or adjusting the dosage without consulting your doctor first. Stopping some medications too quickly can cause serious problems. For example, stopping an anti-seizure medication cold turkey can actually cause seizures. Always consult the person who’s managing your meds before making any changes.


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3 Comments to
“Do I Have to Take Medicine Forever?”

My wife is bi polar and constantly stops taking her meds and hides it! It causes her to be violent and to call 911 saying i abuse her if she dont get her way! She has tried to commit suicide before! She has been off her meds for a while now and has been extreamly depressed and have no fisical and sexual desire for me! Now she has called and had me arested for abuse that didnt happen! I have begged her to take her meds! Abilify and lexapro! She said last that she wont take meds for us to get better but would for kids! What do i do?? Is this common?
She has done this several times in the past 2 years since being diagnosed after our daughter was born! She will move out or have me arested and later come back! She also accused my step sons father of molesting him 3 months ago and later dropped it! It only happens when she is off her meds! Can anyone help me!!!

I have a cousin who is bi–polar and she is a grown woman and I think shes been thru the mill so to speak with lots of things that have bothered her/ mainly to do with her sickness. She takes her meds every day but she had a terrible diet. Chips; cottage cheese and a soda was her thing. She would sleep many hours past 8. Until one day she was at my house and watching me count Vitamin D and calcium plus keeping track of protein and calories I ate. (I am lowering my weight & cholesterol)-she told me she ate whatever she wanted but does what you are doing really work? I told her it works for me but I told her to talk to your doctor first if you plan any changes cause if you change your diet to fast you might have problems. My doctor started me on the right path but Ive read alot too about nutrition. I use to live on coffee and donuts once/ and get many headaches daily and had trouble sleeping–not anymore. I feel if a person eats a more balanced diet–it might make them feel better physically. Its done this to me. I cant cure someones bi-polar sickness and maybe all the diet information wont work on everybody but maybe it will only help a few? Or make someone more comfortable..

I am desperate, my husband was recently diagnosed with adhd- bipolar/psychosis, and does not want to take his meds, because he says he feels fine without them. Well as his wife I can tell its hurting him but he doesnt want to listen, he just gets very angry and says hurtful things. What will happen if he continues not too take them?

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Candida Fink, M.D. and Joe Kraynak are authors of Bipolar Disorder for Dummies. Pick up the book today!
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