Antipsychotic medications are used as a short or long-term treatments for bipolar disorder to control psychotic symptoms such as hallucinations, delusions, or mania symptoms. These symptoms may occur during acute mania or severe depression. Some also treat bipolar depression, and several have demonstrated long-term value in preventing future episodes of mania or depression.

In people with bipolar disorder, antipsychotics are also used “off label” as sedatives, for insomnia, anxiety, and/or agitation. Often, they are taken with a mood-stabilizing drug and can decrease symptoms of mania until mood stabilizers take full effect.

Some antipsychotics seem to help stabilize moods on their own. As a result, they may be used alone as long-term treatment for people who don’t tolerate or respond to lithium (Eskalith, Lithobid) and anticonvulsants.

Antipsychotic drugs help regulate the functioning of brain circuits that control thinking, mood, and perception. It is not clear exactly how these drugs work, but they usually improve manic episodes quickly.

The newer antipsychotics usually act quickly and can help you avoid the reckless and impulsive behaviors associated with mania. More normal thinking often is restored within a few weeks.