The best treatment for bipolar disorder I is steady wellness over a long period of time. That means always taking your medicine. But many people with bipolar disorder find it hard to stay on top of a daily pill schedule – especially when they’re in a depressive or manic episode.
But it’s possible to get shots that let you go longer between doses. Extended-release injectable antipsychotic medications – shots that deliver drugs that work for an extended period of time in your body – can improve your chances of sticking to a treatment plan for longer. They may work better, too.
What Extended-Release Injectables Do
Many people take a mood-stabilizing drug by mouth as their treatment for bipolar I. If this medication doesn’t work well enough, your doctor may either add on or switch you to a daily antipsychotic medication.
If that plan suits your needs and lifestyle, great. If not, injections can be more convenient – though you do have to go to the doctor’s office to get the shot every time.
The drugs you get in an extended-release injectable stabilize your mood so you’re more even-keeled. That way, you don’t dip down into a depressed mood and then swing up into a manic state. These drugs also help reduce disorganized thinking and problems with memory and concentration.
Pros of Extended-Release Injectables
When it comes to ongoing diseases that require a daily pill for treatment, especially mental health conditions, people tend to struggle to take their meds as often as they should. Studies show that only about 4 in 10 people with bipolar I whose doctors prescribe oral antipsychotic medications take them as they should.
On the other hand, people who take extended-release injections tend to stay on their treatment longer. Research shows they get more time between mood episodes and they are less likely to end up in the hospital.
Who Can Benefit From Injectables?
Doctors consider several things to help decide whether an injectable is the right choice for their patient’s bipolar I treatment. They’ll ask:
How frequently you have relapses. If your quality of life is hurt by the number of mood episodes you have, an extended-release injectable may be a solution to keep your system in better balance.
How severe your episodes are. Even if you’re not relapsing often, severe mood episodes that send you to the hospital or take you out of your everyday life are a sign you may need an extended-release injectable.
How well you’re sticking to your current treatment. Many people struggle to remember to take a pill every day. A single shot, depending on which one you take, can last you two to eight weeks. Some people find it easier to stick to this treatment plan because it requires fewer doses, which they remember to take because each dose requires a doctor’s appointment.
Your preferences. You may simply like getting a shot every few weeks or months rather than swallowing a pill every day.
Downsides of Injectable Antipsychotics
For the most part, all antipsychotics for bipolar disorder, whether you take them by mouth or as a shot, come with the same side effects. You may have:
- Involuntary muscle movements
- Drowsiness
- Weight gain
- Higher cholesterol or blood sugar
- Type 2 diabetes
- Heart problems
- Irregular periods
- Problems having sex
The only side effect that’s unique to injections is a possible reaction at the place where the needle went in. You may have:
- Swelling
- Redness
- Pain
These symptoms should not last long. They typically go away within a few days of getting your shot.
Other than side effects, you may not tolerate needles well, or even have a fear – or phobia – of them. If that’s the case, an oral medication may be easier for you even if that means you have to remember to take it every day.
The Bottom Line
Doctors are turning to extended-release antipsychotic injections as a first-line treatment for bipolar I because they are more convenient and often more effective for many people. They may not be for everyone, but they are helping many people live better with bipolar disorder.
Talk to your doctor about whether long-term injectables could be right for you. A doctor can help you weigh the pros and cons by considering your specific condition, lifestyle, and preferences for your bipolar I treatment plan.
Show Sources
Photo Credit: Cavan/Getty Images
SOURCES:
Progress in Mind Psychiatry & Neurology Resource Center: “Which patients benefit from long-acting injectable (LAI) atypical antipsychotic?”
Mayo Clinic: “Bipolar treatment: Are bipolar I and bipolar II treated differently?”
MyHealth.Alberta.ca: “Learning About Long-Acting Injectable Antipsychotic Medicines.”
Therapeutic Advances in Psychopharmacology: “Medication nonadherence in bipolar disorder: a narrative review.”
Journal of Clinical Pharmacology: “Adherence to Antipsychotic Medication in Bipolar Disorder and Schizophrenic Patients.”
St. Luke’s: “Understanding Post-Injection Inflammation.”
