Second line treatment options are lithium, lamotrigine, or the antidepressants sertraline or venlafaxine (for people who experience a pure depressive episode, not with mixed symptoms.)Third line treatment includes divalproex; fluoxetine for individuals who mainly have pure depression; or ziprasidone for individuals who have depression with mixed hypomania, in addition to other medications.Medication for Maintenance TreatmentMedication also is the foundation of maintenance treatment for bipolar disorder, which helps to prevent relapse, reduce symptoms, and improve quality of life. You’ll likely continue taking whatever medication helped you effectively treat your acute episode (with a few exceptions, such as antidepressants, because they can trigger mania in bipolar I).Don’t abruptly stop taking your medication. Always talk to your doctor first.
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