I was diagnosed with rapid-cycling bipolar disorder about 13 years ago. Now I’ve noticed that I have been on less than the recommended dose of lithium and Depakote. My doctor wants to take me off of these medications and try just an antidepressant. I haven’t seen a psychiatrist for several years but was hospitalized about three years ago for depression. What do you think? Can bipolar disorder go away on its own?
Your question has to do with maintenance treatment for someone with bipolar disorder who presumably has been free of episodes of mania and depression for three years. To prevent or decrease the frequency of further episodes, maintenance (or prophylactic) treatment is employed.
Lithium is the main agent, but increasingly other drugs are used instead of or in addition to it. Divalproex or valproic acid (Depakote and Depakene) and carbamazapine (Tegretal) are the main so-called “mood stabilizers” used.
Antidepressants are used in the treatment of depressive episodes but generally are not used for long-term maintenance. Indeed, the use of antidepressants, especially alone, can cause manic episodes and instability, especially in rapid-cycling patients.
Individuals who are stable for a long time and who have mild histories may be considered for cessation of maintenance treatment. This should be done with caution under supervision. I’d have to know a lot more about your particular history to know whether stopping drugs is a good idea for you. However, I think it would be a good idea for you to get input about this very important subject from an experienced psychiatrist.