Treatments and drugs

By Mayo Clinic Staff

Cyclothymia requires lifelong treatment — even during periods when you feel better — usually guided by a mental health provider skilled in treating the condition.

To treat cyclothymia, your doctor or mental health provider aims to:

  • Decrease your risk of bipolar disorder I or II, since cyclothymia carries a high risk of developing into more severe bipolar disorder
  • Reduce the frequency and severity of your symptoms, allowing you to live a more balanced and enjoyable life
  • Prevent a relapse of symptoms, through continued treatment during periods of remission (maintenance treatment)
  • Treat alcohol or other substance abuse problems, since they can worsen cyclothymia symptoms

The main treatments for cyclothymia are medications and psychotherapy.

Medications

Medications may help control cyclothymia symptoms and prevent episodes of hypomania and depression. Medications used to treat cyclothymia include:

  • Mood stabilizers. Mood stabilizers help regulate and stabilize mood so that you don't swing between depression and hypomania. Lithium (Lithobid) has been widely used as a mood stabilizer. Anti-seizure medications, also known as anticonvulsants, are also used to prevent mood swings. Examples include valproic acid (Depakene), divalproex sodium (Depakote), carbamazepine (Tegretol, Equetro, others) and lamotrigine (Lamictal). Your doctor may recommend that you take mood stabilizers for the rest of your life to prevent and treat hypomanic episodes.
  • Antipsychotics. Certain antipsychotic medications — such as olanzapine (Zyprexa), quetiapine (Seroquel) and risperidone (Risperdal) — may help people who don't benefit from the mood-stabilizing effects of anti-seizure medications.
  • Anti-anxiety medications. Anti-anxiety medications, such as benzodiazepines, may help improve sleep.
  • Antidepressants. Use of antidepressants for cyclothymia is typically not recommended, unless they're combined with a mood stabilizer or antipsychotic. As with bipolar disorder I or II, taking antidepressants alone can trigger potentially dangerous manic episodes. Before taking antidepressants, carefully weigh the pros and cons with your doctor.

If one medication doesn't work well for you, there are many others to consider. Keep trying until you find one that works well for you. Your doctor may advise combining certain medications for maximum effect. It can take several weeks after first starting a medication to notice an improvement in your cyclothymia symptoms.

All medications have side effects and possible health risks. Talk to your doctor about the benefits and risks.

Medications such as mood stabilizers may harm a developing fetus or nursing infant. Women with cyclothymic disorder who want to become pregnant or do become pregnant must fully explore with their health care providers the benefits and risks of medications.

Psychotherapy

Psychotherapy, also called counseling or talk therapy, can help you understand what cyclothymia is and how it's treated.

Types of therapy that may help cyclothymia include:

  • Cognitive behavioral therapy. Cognitive behavioral therapy helps you identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones. In addition, you can explore what triggers your hypomanic or depressive episodes and learn how to manage stress and cope with upsetting situations.
  • Family therapy. Family therapy helps you and your family members learn how to communicate, solve problems and resolve conflicts with each other. Family therapy helps identify stressors within the family that may contribute to unhealthy behavior patterns. Your family may also gain a better understanding of your condition and why you think and behave the way you do.
  • Group therapy. Group therapy provides a forum to communicate with and learn from others in a similar situation. It may also help build better relationship skills.
  • Interpersonal social rhythm therapy. This type of therapy helps you manage your daily routines (including your sleep schedule), improve your relationships and develop better communication skills so that interpersonal problems don't disrupt your routines.
Jun. 13, 2012