For these reasons, psychiatrists recommend that people stay on lithium for at least 2 years before they consider discontinuing treatment. Mental confusion, unable to concentrate, acne, which has not gone away after two years, enlarged thyroid and hypothyroidism. When combined with carbamazepine or divalproex, lithium can work for people who previously did not respond to it. Anticonvulsants can be a first-line treatment, especially for people who have mixed or dysphoric bipolar states. One study 8 suggested that people with a history of substance abuse were more likely to benefit from this drug than lithium.
Researchers are still unclear how anticonvulsants improve symptoms of bipolar illness.
9 Carbamazepine and divalproex can have quite severe side effects. These drugs may have less severe side effects, although of course they have some side effects. Gabapentin has been linked with weight gain and hypotension. These drugs are undergoing clinical trials and their use in bipolar illness has not yet been approved. Antidepressants Antidepressants are usually given to treat depression in bipolar illness.