Women’s Sexuality and Bipolar Disorder
What are the side effects of medication for bipolar disorder?
Side effects can occur with all medications, not just psychotropic medications. In bipolar disorder however, medications are taken for long periods, so some side effects may not be tolerable because of the duration of treatment required. Side effects vary both within a class of medications and between classes, although the group of atypical antipsychotics have more similar side-effect profiles than the group of anticonvulsants, for example.
In the case of antidepressants, there are even greater similarities within groups (i.e., SSRIs versus tricyclics). Even if medications of one class share similar side effects, however, the same effect will not necessarily occur with a change to another agent in the same class.
Some medications have rare but serious side effects as well as long-term risks. Your doctor should go over these with you. Some side effects can be useful in certain situations. For example, in a person who has insomnia, a more sedating medication may be helpful.
When taken in the evening. In someone with poor appetite, a medication with associated increase in appetite may be desired.
Do not discontinue a medication when there is a suspected, bothersome side effect; speak with your doctor first. Some side effects are transient or can be easily alleviated by another remedy (e.g., ibuprofen for headache). Stopping medications abruptly when any side effect occurs may cause a discontinuation syndrome, as well as prematurely interrupt a potentially helpful treatment intervention. If possible it is best to remain on a medication for at least a few days, as some perceived side effects could be associated with unrelated conditions (e.g., viral infection). Bear in mind, scientific studies that compare an active medication to a placebo (sugar pill) have reported “side effects” in the placebo group as well. That said, if a suspected effect seems dangerous for any reason, it certainly is most prudent to stop the medication until you are able to speak with your doctor, and if necessary be evaluated in an emergency setting.
Adverse effects of medications used in the treatment of bipolar disorder
Medication Potential -Adverse Effects
Valproate/valproic acid (Depakote, Depakote ER) – Abdominal pain, alopecia, anorexia, diarrhea, irregular menstrual periods, nausea, tremor, vomiting, weight gain, somnolence, blurred vision, thrombocytopenia, liver failure, pancreatitis lithium
(Lithobid, Eskalith) – Tremor, excessive urination, thirst, nausea, diarrhea, sedation, urinary incontinence, acne, weight gain, hypothyroidism, renal dysfunction
Carbamazepine/XR (Tegretol †, Equetro) – Dizziness, drowsiness, nausea, vomiting, bone marrow suppression, rash, hypersensitivity reactions, blurred vision, impaired cognition, hyponatremia, diarrhea
Oxcarbamazepine (Trileptal)† – Abdominal pain, blurred vision, dizziness, fatigue, tremor, headache, nausea, vomiting
Lamotrigine (Lamictal) – Blurred vision, dizziness, sedation, nausea, anxiety, rash, tremor, blood dyscrasias, Stevens-Johnson syndrome
Tiagabine (Gabitril)† – Chills, diarrhea, impaired concentration, dizziness, bruising, fever, depression, seizure (off-label usage in nonepilepsy patients has resulted in onset of seizure disorder)
Topiramate (Topamax)† – Amnesia, impaired concentration, diarrhea, blurred vision, impaired cognition, fatigue, weakness, irregular menstrual periods, gait disturbance, anxiety, mood problems, metabolic acidosis, liver failure, pancreatitis
Gabapentin (Neurontin) † – Blurred vision, dizziness, sedation, dyskinesia, nystagmus, edema, tremors, visual changes, mood changes
Olanzapine/fluoxetine (Symbyax) – Side effect profile of olanzapine plus anxiety, diarrhea, insomnia, nausea, headache, sexual dysfunction
Clozapine (Clozaril)† – Constipation, dizziness, sedation, fever, nausea, sialorrhea, weight gain, arrhythmia, agranulocytosis, blood dyscrasias
Risperidone (Risperdal) – Agitation, sedation, headache, dizziness, constipation, diarrhea, rhinitis, blurred vision, akathisia, extrapyramidal symptoms, weight gain, amenorrhea, galactorhea, and diabetes
Olanzapine (Zyprexa, Zydis) – Constipation, dry mouth, weight gain, sedation, dizziness, akathisia, tremor, increased appetite, rhinitis, diabetes, hypercholesterolemia, elevated triglycerides, blurred vision, edema
Quetiapine (Seroquel) – Headache, dizziness, constipation, dry mouth, hypotension, sedation, rhinitis, diabetes, weight gain, hypercholesterolemia, elevated triglycerides, cataracts, arrhythmias
Ziprasidone (Geodon) – Nausea, constipation, diarrhea, dry mouth, sedation, dizziness, sialorrhea, headache, tremor, arrhythmias, weight gain
Aripiprazole (Abilify) – Headache, blurred vision, rhinitis, cough, tremor, anxiety, insomnia, nausea, sedation, constipation, sialorrhea, edema, weight gain
* Listed adverse effects are not exhaustive of side effects as reported in the Physicians’ Desk Reference.
More common effects were included, as well as some more serious effects. Any concern about an adverse effect from a medication should be discussed with your doctor.
† Does not have an FDA indication for bipolar disorder
Adverse effects of antidepressants by class Medication class Potential adverse effects*
SSRIs – Nausea, diarrhea, insomnia, anxiety, nervousness, dizziness, somnolence, tremor, decreased libido, sweating, anorexia, dry mouth, headache, sexual dysfunction, serotonin syndrome
TCAs – Dry mouth, constipation, nausea, anorexia, weight gain, sweating, increased appetite, nervousness, decreased libido, dizziness, tremor, somnolence, blurred vision, tachycardia, urinary hesitancy, hypotension, cardiac toxicity
MAOIs – Dizziness, headache, drowsiness, hypotension, insomnia, agitation, dry mouth, constipation, nausea, urinary hesitancy, weight gain, edema, sexual dysfunction, increased liver enzymes, toxic food, and drug interactions
Others (drugs listed separately)
Bupropion (Wellbutrin) – Weight loss, dry mouth, rash, sweating, agitation, dizziness, insomnia, nausea, abdominal pain, weakness, headache, blurred vision, constipation, tremor, rapid heart rate, ringing in ears, seizures
Venlafaxine (Effexor) – Sweating, nausea, constipation, decreased appetite, vomiting, insomnia, somnolence, dry mouth, dizziness, nervousness, tremor, blurred vision, sexual dysfunction, rapid heart rate, and hypertension
Duloxetine (Cymbalta) – Nausea, dry mouth, consitpation, loss of appetite, fatigue, drowsiness, dizziness, sweating, blurred vision, rash, itching, sexual dysfunction, tremor, unusual bleeding
Mirtazapine (Remeron) – Somnolence, appetite increase, weight gain, dizziness, dry mouth, constipation, hypotension, abnormal dreams, flu syndrome, low blood cell counts
Nefazadone (Serzone) – Somnolence, dry mouth, nausea, dizziness, insomnia, agitation, constipation, abnormal vision, confusion, liver failure
Trazadone (Desyrel) – Sedation, hypotension, dizziness, blurred vision, headache, loss of appetite, sweating, restlessness, rapid heart rate, prolonged erection
* Listed adverse effects are not exhaustive of side effects as reported in the Physicians’ Desk Reference.
Rather more common effects within each group were included, as well as some more serious effects. Side-effect profiles of medications within a class may vary. Any concern about an adverse effect from a medication should be discussed with your doctor.
Discontinuation syndrome – Physical and psychological symptoms that occur when a drug is suddenly stopped.
Next: Will I become addicted to the medication?
