Bipolar disorder is a chronic condition with a wide range of possible symptoms. The National Alliance on Mental Illness notes that in addition to the alternating periods of elevated and depressed moods which primarily characterize the disorder, possible symptoms include anxiety, irritability and difficulties with sleep.
Because of the wide range of symptoms, doctors often prescribe a variety of medications including benzodiazepine drugs like clonazepam.
Treating Mania and Depression in Patients Suffering from Bipolar Disorder
A New York Times health guide states that the primary goals of bipolar disorder treatment are to reduce the severity and frequency of manic and depressive episodes, help patients avoid cycling from one phase to another and improve patient functioning. They note that treatment has some unique challenges, including that the varying mood states of the condition, make it hard to determine if changes are due to treatment or to the nature of the disease itself. They note that it may also be difficult for patients to fully communicate the state of their illness.
Manic episodes are treated differently than are depressive episodes. Treating mania includes eliminating any medications or other substances that may be contributing to the mood state. Mood stabilizers like valproate, carbamazepine, or lithium are commonly used.
When necessary, antipsychotic drugs may be added. The New York Times guide notes that benzodiazepine drugs like clonazepam may be particularly useful when patients experience severe mania. They note that when improvement is noted, antipsychotic and benzodiazepine drugs should be slowly withdrawn.
Contrary to what is generally prescribed for other types of depression, the first-line treatment for the depression of bipolar illness is not generally an antidepressant because in patients with bipolar disorder antidepressants may trigger manic episodes. The mood stabilizer and anticonvulsant drug lamotrigine is often used, and for patients who do not improve after two to four weeks, select antidepressants like bupropion or paroxetine may be added. For patients who have mixed episodes or rapid cycling, lithium, valproate, or lamotrigine are primary treatments and some atypical antipsychotic drugs may also be useful. Antidepressants are usually tapered off because they may contribute to the condition.
The New York Times guide notes that it is wise for patients who experience mixed episodes or rapid cycling to avoid caffeine, drugs, alcohol or anti-anxiety medication like clonazepam.
The Use of Benzodiazepine Drugs in Bipolar Disorder
Benzodiazepines like clonazepam are used to treat anxiety, sleep disorders, and mania because they are central nervous system (CNS) depressants. Drugs in the category slow brain function. The Center for Substance Abuse Research explains that they do this by enhancing the activity of the neurotransmitter GABA, which inhibits motor neurons.
Although benzodiazepine drugs can be very effective, they can also be strongly habit-forming. A website associated with Stanford University notes that dependency, both psychological and physical, may develop in only two to four weeks of use. Drug tolerance often causes people to need increasing dosages to achieve effects formerly received from a smaller amount of the medication.
Once dependence has developed, stopping the drug abruptly can cause a range of withdrawal symptoms including some that are difficult to distinguish from symptoms of bipolar illness including behavioral disorders, depression, hallucinations, restlessness, and insomnia.
Although anyone can become addicted to benzodiazepine drugs like clonazepam, people suffering from mental health conditions like bipolar disorder may be at increased risk. Mental health disorders and addiction often occur together. The medical website WebMD notes that mental health disorders and substance abuse often co-exist because each makes people more vulnerable to experiencing the other.
The site also notes that an estimated 60% or more of people suffering from either addiction or a mental health disorder are also suffering from the other condition. Because of the correlation, it is important that the use of potentially addicting drugs to treat bipolar disorder be monitored closely and that any signs of addiction be addressed.
Integrated Treatment for Addiction and Bipolar Disorder
When people suffering from bipolar disorder do develop substance addiction, it is wise to address both conditions in a coordinated way. Integrated treatment, which treats both disorders simultaneously and preferably within the same treatment facility, leads to the best treatment outcomes. Ongoing monitoring is important as the treatment progresses since treatment may need to be modified as symptoms change.
If you or a loved one suffers from bipolar disorder and addiction to clonazepam or any other substance, we can help you find integrated treatment. Call us at 855-808-6212. We can answer your questions and can even check your insurance coverage at no cost or obligation. Treatment is available. We can help you find it, so call now.
