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Strategies to limit side effects[/b:99e820e8f7]
All of the medications that are used to treat bipolar disorder can
produce bothersome side effects; there are also some serious but rare
medical reactions. Just as different people have varying responses to
different medications, the type of side effects different people develop
can vary widely, and some people may not have any side effects at all.
Also, if someone has problems with side effects on 1 medication, this
does not mean that that person will develop troublesome side effects
on another medication.
Certain strategies can help prevent or minimize side effects. For
example, the doctor may want to start at a low dose and adjust the
medication to higher doses very slowly. Although this may mean that
you need to wait longer to see if the medication will help the symp-toms,
it does reduce the chances of side effects developing. In the case
of lithium or divalproex, blood level monitoring is very important to
insure that a patient is receiving enough medication to help, but not
more than is necessary. If side effects do occur, the dosage can
frequently be adjusted to eliminate the side effects or another medi-cation
can be added to help. It is important to discuss your concerns
about side effects and any problems you may be experiencing with
your doctor, so that he or she can take these into account in planning
your treatment.
cornerstones of prevention or long-term maintenance treatment.
About 1 in 3 people with bipolar disorder will remain completely
free of symptoms just by taking mood stabilizing medication for
life. Most other people experience a great reduction in the fre-quency
and severity of episodes during maintenance treatment.
It is important not to become overly discouraged when episodes
do occur and to recognize that the success of treatment can only be
evaluated over the long term, by looking at the frequency and
severity of episodes. Be sure to report changes in mood to your
doctor immediately, because adjustments in your medicine at the
first warning signs can often restore normal mood and head off a
full-blown episode. Medication adjustments should be viewed as a
routine part of treatment (just as insulin doses are changed from
time to time in diabetes). Most patients with bipolar disorder do
best on a combination or “cocktail” of medications. Often the best
response is achieved with 1 or more mood stabilizers, supple-mented
from time to time with an antidepressant or possibly an
antipsychotic medication.
Continuing to take medication correctly and as prescribed
(which is called adherence) on a long-term basis is difficult whether
you are being treated for a medical condition (such as high blood
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