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Medication for Teen Bipolar Disorder: A Parent’s Guide

Medication for Teen Bipolar_ A Parents Guide

Did you know that an estimated 2.9% of teens live with bipolar disorder? Out of them, 2.6% have severe impairments. Bipolar disorder causes intense changes in moods and energy levels. It can impact different areas of a teenager’s life. These include social, academic, and occupational aspects. When addressing it, treatment professionals use medications alongside holistic and therapeutic interventions. Fortunately, the FDA has approved certain drugs to be used in teen bipolar disorder treatment.

At Nexus Teen Academy, we understand the challenges teens with bipolar disorders face. We have teams of treatment professionals specialized and experienced in teen mental health treatment. We are ready to help your teen navigate the challenges of bipolar and any other co-occurring disorders. Join us as one of our treatment professionals discusses some commonly used medications in teen bipolar disorder treatment.

Understanding Teen Bipolar Disorder

Teen bipolar disorder

Teen bipolar disorder usually manifests as intense or extreme ups and downs in a teenager’s moods and energy. It comprises alternating manic, hypomanic, and depressive episodes that can last for several days or weeks. Both manic and hypomanic episodes are signified by increased activity, agitation, and energy. Other manifestations include an abnormal upbeat, jumpy, or wired mood. Teens may also experience reduced sleep and an exaggerated sense of well-being and confidence. 

On the other hand, depressive episodes are signified by a depressed mood, loss of interest in daily or social activities, and restlessness. Teens may also experience slowed behavior, suicidal thoughts or ideations, and pervasive feelings of worthlessness. Other relatively common signs include fatigue and loss of energy. Without tailored, comprehensive treatment, teen bipolar disorder can result in the following issues: 

  • Poor school or work performance
  • Suicide or suicidal attempts
  • Drug and alcohol use challenges 
  • Legal or financial issues
  • Relationship breakdowns and social issues

FDA-Approved Medications for Teen Bipolar Disorder

FDA-Approved Medications for Teen Bipolar Disorder

The United States Food and Drugs Authority seeks to protect the health of US citizens. It guarantees consumers safe, efficient, and secure human and veterinary drugs. It has approved certain medications to be used in teen bipolar disorder treatment. These are usually grouped into mood stabilizers, anticonvulsants, atypical antipsychotics, and antidepressants. 

In addition to FDA-approved medications, treatment professionals can prescribe off-label medicines. However, such medicines must have been proven to be safe and efficient for the younger generation. Off-label medicine prescriptions are usually based on clinical judgments. Here are the common drugs used to treat teen bipolar disorder:

Mood Stabilizers

As the name suggests, mood stabilizers help reduce the intensity of mood swings. Some can also prevent the recurrence of manic or depressive episodes. Common mood stabilizers used in bipolar disorder treatment include the following: 

Lithium

The FDA recommends using lithium for manic episodes. However, lithium is often underutilized owing to concerns or fears about its old status and potential for adverse effects. However, that doesn’t stop it from being the “first-line choice” or “gold standard” when treating bipolar disorder.

How Does Lithium Work?

It is believed that lithium works by balancing brain neurotransmitters, stabilizing moods, and preventing future episodes. It is taken as an oral tablet and requires consistent blood work to determine the right dosage. Lithium is not recommended for teens with certain conditions. These include renal and cardiovascular diseases, sodium depletion, severe debilitation, and dehydration. It shouldn’t also be used on teens receiving diuretics as they are increasingly vulnerable to lithium toxicity.

Side Effects of Lithium for Teen Bipolar Disorder

Possible side effects of lithium include: 

  • Headache
  • Drowsiness
  • Diarrhea
  • Nausea
  • Vertigo
  • Excessive thirst
  • Weight gain
  • Frequent urination
  • Fatigue
  • Cognitive issues, such as concentration and focusing challenges 

Besides the above side effects, remember to monitor your teenager’s diet and bloodwork.

Anticonvulsants

Anticonvulsants are usually considered “off-label” medications. This is because they have not been specifically approved by the FDA for teen bipolar disorder treatment. Before bipolar treatment professionals started including them in treatment plans, they were used to prevent seizures. This was common in epileptic patients. Despite the differences between the two conditions, epilepsy, and bipolar disorder both stem from the overexcitability of the brain’s nerve cells or neurons. 

How Do Anticonvulsants Work?

Anticonvulsants work by targeting ion channels in the cell membrane. As a result, they alter electrical activity in neurons and create a calmer, relaxed brain. There are a handful of anticonvulsants used in teen bipolar disorder treatment. They include lamotrigine, topiramate, divalproex, and carbamazepine.

Side Effects of Anticonvulsants for Teen Bipolar Disorder

Side effects likely to be witnessed in teens who use anticonvulsants include: 

  • Drowsiness
  • Nausea
  • Diarrhea
  • Tremors
  • Weight gain
  • Dizziness

Atypical Antipsychotics

The FDA approves certain atypical psychotics (Risperidone, Zyprexa, and Abilify) to be used in treating bipolar disorder in patients under 17 years. Atypical or second-generation antipsychotics are commonly used during manic episodes or to treat psychosis. Psychosis makes it challenging to differentiate reality from illusion. These drugs have a strong, calming effect. They also produce fewer side effects. These two factors may explain their popularity in teen bipolar disorder treatment. 

How Do Atypical Antipsychotics Work?

Atypical antipsychotics work by adjusting the chemicals in the brain. Just like lithium, they can prevent the occurrence of a future episode. Atypical antipsychotics allow teenagers to maintain stability while simultaneously avoiding the re-occurrence of bipolar episodes.

Side Effects of Atypical Psychotics for Teen Bipolar Disorder

Common side effects of atypical psychotics include:

  • Dizziness
  • Nausea
  • Exhaustion
  • Weight gain
  • A dry mouth

Antidepressants

Unlike atypical antipsychotics, antidepressants are used to treat depressive episodes of bipolar disorder. Depressive episodes are characterized by persistent feelings of sadness, hopelessness, and worthlessness. Despite their popularity, antidepressants are not usually the first choice of drugs during bipolar disorder treatment. This is because they may cause manic symptoms in some teenagers. The only antidepressants approved by the FDA for use in teenagers are Prozac and Lexapro. 

How Do Antidepressants Work?

Here are the two main types of antidepressants and how they work:

  • Serotonin and Noradrenaline Reuptake Inhibitors (SNRIs): SNRIs help stabilize moods by raising the levels of norepinephrine and serotonin neurotransmitters in the brain. Although not approved by the FDA for teen depression treatment, common SNRIs include venlafaxine (Effexor) and duloxetine (Cymbalta).
  • Selective Serotonin Reuptake Inhibitors (SSRIs): As the name suggests, SSRIs block serotonin from quickly exiting the brain. This raises its levels. They, therefore, ensure that teenagers have enough serotonin to regulate their moods. Commonly used SSRIs include escitalopram (Celexa), fluoxetine (Prozac), escitalopram (Lexapro), and citalopram (Celexa).

Side Effects of Antidepressants for Teen Bipolar Disorder

SSNRIs and SSRIs share the following side effects: 

  • Headaches 
  • Dizziness 
  • Dry mouth 
  • Sleep difficulties and insomnia 
  • Appetite/ weight changes 
  • Gastrointestinal issues, such as nausea and stomach upset.

Tips for Parents on Monitoring and Managing Side Effects

The following tips should help you monitor and manage the side effects of the above medications: 

  • Learn more about the potential side effects of your teenager’s medications and how to manage them best. 
  • Regularly ask your teenager how they feel. Inquire about the changes they may have noticed. 
  • Pay attention to any adverse changes in mood and behavior. Additionally, look out for any physical signs of discomfort. 
  • Track the severity and duration of your teen’s side effects. A mood journal may help.
  • Promptly discuss any side effects or concerns with the treatment team or provider. 
  • Actively manage specific symptoms in collaboration with your teenager and treatment specialists. This may require adjusting the dosage, incorporating supportive measures, and using alternative medications.

Deciding the Right Medication

At Nexus Teen Academy, we conduct comprehensive evaluations and assessments when treating teens. This allows us to make accurate diagnoses for effective treatment or medication planning. Here are some of the factors we consider when coming up with the right medication regimens: 

Type and Severity of Symptoms

Teen bipolar disorder manifests differently depending on the episode and the teen. We consider the type of symptoms and their severity when prescribing medications to promote individualized treatment. This can lead to relatively quick relief or stability. For example, we prescribe antidepressants for depressive episodes. Antidepressants target the symptoms of depression. 

The Teenager’s Medical History and Physical Health

We understand the potential interactions bipolar medications may have with any drug your teenager may be currently taking. Therefore, we will consider their physical health and current medical history when prescribing medications. This promotes safety. 

Medication Tolerance and Potential Side Effects

Individuals react differently to medications. Therefore, we carefully monitor teenagers for intolerances and anticipate any adverse effects when preparing regimens.

Teen’s Family History

Bipolar disorder often runs in families. Therefore, we have to consider a teen’s family history when addressing bipolar disorder. This allows us to identify the best treatment options and anticipate the teen’s potential responses. 

Treatment Goals

Treatment goals often depend on the teenager’s needs and circumstances. We aim to stabilize mood episodes and avoid relapse when treating some teens. For others, we seek to improve their overall functioning and life quality. Therefore, treatment goals dictate the medication prescribed. 

Teen and Family Preferences

We allow family members and teenagers to participate in treatment decision-making. We will only settle on medications after discussing treatment options with you. We will also brief you on the potential benefits and risks of different medication options for informed decision-making. 

Clinical Guidelines and Evidence-Based Practices

We heavily rely on evidence-based practices and clinical guidelines when prescribing medications. These are usually set by organizations such as the American Academy of Child and Adolescent Psychiatry (AACAP) and the American Psychiatric Association (APA). Such guidelines help us make decisions based on the most recent research developments. 

Managing Medication: Tips for Parents

Managing Medication Tips for Parents

Here are a few tips for managing teen bipolar medications efficiently: 

  • Educate yourself about bipolar disorder and your teen’s prescribed medications. This will help you know the expected side effects and how to manage them. 
  • Help your teenager adhere to the prescribed medications. They should take them every day and at the same time. You can also enhance their adherence through a stable daily routine. 
  •  Monitor your teen. Pay close attention to any mood changes and side effects. 
  • Maintain open communication with the treatment team or psychiatrist. This makes discussing any concerns, changes, side effects, and necessary adjustments easier. 
  • Teach your teenager about their condition and why they should comply with the prescribed medications. 
  • Address any side effects promptly. Remember to inform the psychiatrist or treatment team quickly to prevent further complications. 
  • Engage in self-care activities. Taking care of your mental health needs allows you to offer the best support to your teen.
  • Reduce stressors and triggers by creating a safe, supportive, and understanding home environment. 

Additionally, as you support your teenager’s medication adherence, remember to have an emergency plan in place. Such a plan helps with emergencies, crises, and unexpected mood or behavioral changes. Also, keep updated documentation of your teen’s medication responses.

Conclusion

Teen bipolar disorder can have detrimental effects on a teenager’s life. It’s advisable to get in touch with healthcare professionals as soon as possible for early intervention and support if you notice your teenager’s mood swings getting out of hand. You should also collaborate with them during treatment planning to identify the right treatment options and medications. Remember, bipolar medications can be FDA-approved or off-label. Although FDA-approved medications should be prioritized, be open to safe and effective off-label variants, too. 

At Nexus Teen Academy, we allow parents and family members to participate in their teen’s mental health treatment. We work with you to help you understand the befitting treatment options for your teenager and the potential benefits and risks of different medications. We will also ensure your values and preferences are respected during treatment planning. Contact us for tailored treatment, support, and interventions.

Frequently Asked Questions

A few indicators that your teen may need medication for their bipolar disorder include: 

  • Severe mood swings that impair their daily functioning. 
  • Social and academic challenges. 
  • If psychotherapies and non-medication interventions have failed to manage their symptoms.
  • If the teen’s bipolar symptoms may put them or others at risk.

We involve you and your teenager in treatment decision-making. Our treatment professionals will discuss the available treatment options and their benefits and risks. This helps you make an informed decision regarding your teen’s welfare. 

Yes. Besides medications, teens with bipolar disorder can benefit from psychotherapy and lifestyle interventions. Psychotherapies, such as dialectical behavior therapy (DBT), cognitive behavioral therapy (CBT), and family therapy, promote awareness of bipolar disorder symptoms. They also help teens develop effective coping strategies and distress-tolerance skills. 

On the other hand, lifestyle interventions such as a stable routine and self-care practices make it easier to manage bipolar symptoms. They can also enhance a teenager’s overall well-being.

At Nexus Teen Academy, we approach teen medication management comprehensively and individually. Here are a few components in our medication management approach: 

  • Conducting comprehensive evaluations and assessments. This allows us to make accurate diagnoses and effective treatment plans. 
  • Tailoring evidence-based medication plans and regimens to teenager’s specific needs and symptoms. 
  • Closely monitoring the effectiveness of the medications. We also keep an eye for the teenager’s tolerance levels. 
  • Regularly assessing teens’ treatment goals and making necessary adjustments. 

We will involve you and your teenager in treatment management for better outcomes.

The following may show that your teen’s bipolar medications are effective: 

  • A reduction in mood swings and bipolar episodes. 
  • Improved mood and behaviors.
  • Enhanced daily functioning. This may manifest as enhanced academic participation and social interactions. 
  • Improved sleep patterns. 
  • Positive feedback from the teenager

You should regularly check in with the healthcare provider. Additionally, collaborate with the treatment team to monitor your teen’s medication progress and make any necessary adjustments.

Yes. Besides taking medications, teens with bipolar disorder should attend therapy regularly. Therapy can help them develop effective coping skills and improve their communication. Other benefits of therapy include better relationships with family members, addressing underlying issues, and improved emotional regulation. 

Yes. Your teen’s bipolar medications can be adjusted or changed based on several reasons. These include the emergence /worsening of side effects and changes in symptoms. Insufficient improvements may also warrant a change or an adjustment. Ensure you discuss this with your teen’s healthcare provider before considering a medication change or adjustment. 

How long a teenager stays on bipolar medications depends on several factors. These include their treatment response, symptom severity, and treatment goals. However, note that some bipolar medications are meant for long-term usage. These include medications for mood stabilization and relapse prevention. 

Teenagers with bipolar disorder are usually assessed periodically to determine whether they need ongoing medication, dosage adjustments, or a medication change. Medication can be discontinued for stable or well-managed symptoms.

Common side effects of bipolar medication include:

  • Weight gain
  • Sedation
  • Vomiting
  • Nausea
  • Diarrhea
  • Involuntary tremors
  • Motor disturbances
  • Changes in cholesterol or blood sugar levels
  • Hormonal disruptions
  • Skin-related issues

Here are a few ways of supporting your teen’s mental health beyond medication: 

  • Encouraging them to enroll for and attend regular therapy sessions. They will get a chance to develop effective coping strategies during therapy. 
  • Helping them adopt healthy lifestyle interventions for improved mood and well-being. Examples include getting balanced nutrition, exercising regularly, and obtaining adequate sleep. 
  • Creating a predictable daily routine. This promotes stability and reduces stress. 
  • Creating an open and supportive environment. Teens usually feel comfortable discussing their feelings and experiences in such an environment.
  • Encouraging them to stay connected to supportive friends and peer groups. 
  • Helping them identify and participate in activities they enjoy. 
  • Teaching them stress-reduction techniques. These include mindfulness and deep breathing exercises. 

Remember to also take care of yourself as you support your teenager. This calls for prioritizing your mental health and demonstrating healthy coping skills. 

You should immediately stop the dosage and seek medical attention if your teenager experiences severe side effects. Contact your teen’s healthcare provider as quickly as possible, or rush to the nearest emergency room. Do not administer medications or solutions without express instructions from a qualified specialist or psychiatrist. 

The following resources can benefit parents of bipolar teens: 

  • Online forums or support groups. A good example is DailyStrength
  • Relevant books and journals on teen bipolar disorder 
  • School counselors and psychologists 
  • Professional counseling or therapy services 
  • Organizations such as the National Alliance of Mental Illness (NAMI) or Child Mind Institute

The frequency of medical appointments and check-ins will depend on a handful of factors. These include the treatment plan, overall stability, and symptom severity. Teens may have to visit the treatment center frequently before their symptoms stabilize. These visits allow treatment professionals to monitor medication effectiveness, address emerging issues or symptoms, and make adjustments. 

However, once stable, appointments may happen less frequently, such as every 3-6 months. Therefore, collaborate with your teen’s treatment provider for individualized treatment planning and monitoring.

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