Examples

First-generation, or typical, antipsychotic medicine

Second-generation, or atypical, antipsychotic medicines

These medicines are available in liquid, tablet, or injectable form.

How It Works

These medicines balance certain chemicals in the brain (neurotransmitters). It is not clear exactly how these medicines work for the treatment of bipolar disorder. But they quickly improve manic episodes.

Why It Is Used

Each of these medicines has been approved by the U.S. Food and Drug Administration (FDA) to treat bipolar disorder. Some medicines work better for different people than others. Second-generation antipsychotic medicines may have fewer side effects than first-generation antipsychotic medicines. Be sure to talk with your doctor about how the medicine is working for you. Sometimes you might need to try more than one type of medicine before you find one that works best for you.

These medicines have all been found to be an effective treatment of manic episodes. Quetiapine has been approved by the FDA to treat both mania and depression. Other antipsychotic medicines, such as olanzapine, are also being studied for the treatment of depression in bipolar disorder. The single medicine combining olanzapine and fluoxetine (Symbyax) is also used to treat depressive episodes associated with bipolar disorder. Fluoxetine is a selective serotonin reuptake inhibitor (SSRI), which is used to balance certain brain chemicals (neurotransmitters) that are thought to cause depression.

How Well It Works

Drugs in this classification work quickly in the treatment of bipolar disorder, especially in older adults. These medicines have all been found to be an effective treatment of manic episodes. Some studies show the combination of an antipsychotic and a mood stabilizer may be more effective than a mood stabilizer alone.¹

Side Effects

The use of antipsychotics has also been linked to the risk of movement disorders. The risk of developing a movement disorder is less for newer antipsychotics such as aripiprazole, olanzapine, risperidone, and quetiapine. But it is important to tell your doctor about any abnormal muscle movements.

Also, second-generation antipsychotics may raise the risk of diabetes and/or abnormalities in cholesterol levels.

The most common side effects of olanzapine include dry mouth, constipation, weight gain, drowsiness, and increased appetite.² Other common side effects are shakiness or tremors, slurred speech, and low blood pressure that makes you feel dizzy when you stand up.