-- Question: How do antipsychotics work, when are they used in the treatment of bipolar disorder, and how does one decide which antipsychotic to use?
Answer: There are a number of antipsychotic medications that are approved by the Food and Drug Administration for the acute treatment of mania and depression in bipolar disorder. Because the antipsychotics start to work faster than the mood stabilizing medications, including lithium, they're particularly important when persons are particularly distressed, have sleep disturbance, are overly excited or aggressive.
The way the antipsychotics work in bipolar disorder is they reduce the excitability of nerve cells in that part of the brain that's responsible for the regulation of mood and motivation. The choice of these antipsychotics lay principally on which side effects it's most important to avoid. Some of the antipsychotics can cause increases in blood sugar, can make it like the person is diabetic.
Others can cause sedation, sometimes antipsychotics can cause stiffness. In each instance, once the antipsychotic is stopped, these symptoms or problems should go away. Nonetheless it's important to draw blood and make sure the blood level is not elevated when these medications are started.