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Therapy of bipolar disorders

How should I handle the side effects?

bildIn the course of the medicinal therapy, various side effects may develop. Many of these side effects, however, cannot be seen externally; that is to say, the doctor cannot see whether or not you are suffering from one or the other of these side effects. Consequently, it is imperative that you inform your doctor of them. This is especially the case for functional sexual disturbances, a symptom which it is not easy to speak about. An open discussion frequently solves many problems, allays fears and allows a relationship to develop that which is based on trust. Be patient, though: Most side effects appear at the start of therapy and then disappear on their own. Here, you will find a list with the most frequent side effects and indications concerning what you have to watch out for and what you can do.

Side effects: What I have to be careful of and how I can handle this

Symptoms involving extrapyramidal motor disorders (EMD)

What do I have to be careful of?

  • You feel stiff, heavy and no longer so mobile.
  • Your mood worsens.
  • You may not be able to see so well.
  • In extreme cases, you have troubles when swallowing and find it difficult to look downward.

Significance and what you can do about it

  • Usually occurs at the start of therapy
  • Is substantially more frequent when using older antipsychotics
  • Consult a physician.
  • Let him/her prescribe Biperiden retard for you for a minimum of two weeks.
  • Discuss the possibility of reducing the dose or, if necessary, of changing to a different antipsychotic agent.

Akathisia (= an inability to sit or stand still)

What do I have to be careful of?

  • You are no longer able to sit or stand still.
  • You have a sense of inner restlessness.
  • You have an urge to constantly move or run around.

Significance and what you can do about it

  • See extrapyramidal motor disorders (EMD)

Tardive Dyskinesien (TD)

What do I have to be careful of?

  • Without any intention on your part, you perform chewing movements with your mouth or smack your lips.
  • Without any intention on your part, you move one or another part of your body.

Significance and what you can do about it

  • Consult a physician.
  • Discuss the possibility of reducing the dose or, if necessary, of changing to a different antipsychotic agent or obtaining an additional medication.

Sexual and endocrine (hormonal) disturbances

What do I have to be careful of?

  • You have a reduced desire to partake in sexual interactions.
  • You have problems becoming sexually aroused and in obtaining an orgasm.
  • Your menstruation is missing.
  • You are no longer able to ejaculate.

Significance and what you can do about it

  • Dare to speak about this problem openly!
  • This may occur when undergoing treatment using particular antipsychotics and antidepressive agents.
  • Consult a physician.
  • Have your prolactin level measured; if necessary, also control the oestrogen level in women and the testosterone level in men.
  • Discuss the possibility of reducing the dose or, if necessary, of changing to a different antipsychotic agent or obtaining an additional medication.

Weight gain

What do I have to be careful of?

  • You have a substantially better appetite and hunger, especially for sweets, but also for fatty meals.
  • You suddenly eat much more than previously.
  • Your sense of feeling satiated is no longer reached.
  • You gain a great deal of weight within a short period of time.

Significance and what you can do about it

  • This occurs in association with particular antipsychotics or antidepressants and for certain phase prophylactics, especially when these are administered in combination.
  • Consult a physician.
  • If necessary, discuss the possibility of changing to a different medication.
  • If necessary, obtain some dietary advice.
  • Ask about special training programmes.
  • Try to control your eating habits and, if necessary, adapt them.

Psychic side effects

What do I have to be careful of?

  • You are no longer able to concentrate.
  • You feel tired and powerless.
  • You sleep excessively.
  • You have problems remaining attentive for longer periods of time.
  • You feel as if your memory has become worse.

Significance and what you can do about it

  • The cause could be the illness itself or a side effect of the medication.
  • Consult a physician.
  • Discuss possible causes.
  • Ask whether a neuropsychological test would be possible. Here, based on a number of different tests, an attempt can be made to objectify your observations with regard to your cognitive capabilities.
  • If necessary, discuss making a change to a different medication.
  • Ask about special training programmes, e.g. CogPack or metacognitive training (MCT).

Vegetative side effects

What do I have to be careful of?

  • You are dizzy.
  • Your heart races or beats very intensively.
  • You are constipated or have diarrhoea.
  • You experience a dry mouth or excessive salivation.
  • You sleep poorly.
  • You feel as if your visual acuity has become worse than previously.

Significance and what you can do about it

  • Most of these side effects occur only at the start of therapy and then disappear on their own.
  • If necessary, consult with a physician and discuss the possible therapies, e.g. chewing gum can eliminate the dry mouth, sleeping medication against the sleeping disorders, etc.
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