Managing Bipolar Medication Side Effects: Tips and Strategies
Mental Health ConditionsBipolar Disorder

How to Reduce the Most Common Side Effects of Bipolar Medications Without Stopping Treatment

How to Reduce the Most Common Side Effects of Bipolar Medications Without Stopping Treatment
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Published on January 20, 2026
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Bipolar disorder medications can help manage symptoms, but their side effects may tempt you to stop taking them. Weight gain, fatigue, brain fog, and uncontrollable movements can make it difficult to stick with vital bipolar medications, but if you experience these side effects, you have options.

Each medication type comes with a unique combination of side effects, which should be discussed before you start treatment so you can know what to expect, says Paula Zimbrean, MD, a psychiatrist and a professor of psychiatry and surgery (transplant) at Yale School of Medicine in New Haven, Connecticut. Managing bipolar medication side effects takes teamwork between you and your healthcare provider, but relief is possible.

Weight Gain

Several bipolar medications can make you gain weight and increase your risk of metabolic syndrome, a collection of medical complications such as high blood sugar, blood pressure, and cholesterol. These effects can then raise your risk of diabetes, stroke, and heart disease.

Atypical (second generation) antipsychotics, valproic acid (Depakote), and lithium (Lithobid) can each contribute to weight gain and metabolic changes.

 But some research suggests that clozapine (Clozaril) and olanzapine (Zyprexa) carry the highest risk for these side effects. Quetiapine (Seroquel) may also raise cholesterol, but not as much as clozapine and olanzapine.

If you take these medications, you can take steps to reduce any negative effects. “A healthy diet, exercise, and changing the administration time and dose of the medication can help decrease these side effects,” says Kedon Newton, MD, a psychiatrist at the Center for Behavioral Health at Cleveland Clinic in Ohio.

Calorie Restriction and Exercise

You can prevent weight gain by decreasing the number of calories you eat and drink each day. For optimal weight loss, some studies recommend lowering your caloric intake by 500 to 1,000 calories each day and restricting fat to less than 30 percent of your diet.

Physical activity has benefits for mental health overall, and can also help you shed pounds.

 Experts recommend at least 150 minutes per week of moderate-intensity aerobic activity, like brisk walking, cycling, or swimming.

Medication Changes or Additions

To lessen weight gain and its associated risks, your provider may recommend switching to a different medication. For example, aripiprazole (Abilify) and some newer bipolar drugs, like ziprasidone (Geodon) and lurasidone (Latuda), may cause less weight gain and fewer metabolic symptoms.

 Your provider might also add metformin (Glucophage), which can prevent weight gain associated with antipsychotics.

Drowsiness

Almost all bipolar medications can make you feel tired. Atypical antipsychotics, valproic acid, lamotrigine (Lamictal), lithium, and carbamazepine (Tegretol) all cause drowsiness.

 Some strategies for decreasing sleepiness from bipolar medications include getting good sleep and asking about medication adjustments or the addition of a stimulant.

Adjust Medication Dose or Timing

If your bipolar meds make you too drowsy, you can ask your provider about changing the time you take them or adjusting your dose, if needed.

 “I would recommend changing to bedtime administration to alleviate daytime drowsiness,” says Dr. Newton. Be sure to ask your provider first before you change your medication dose or timing.

Ask About Stimulant Medications

To combat drowsiness, your provider may suggest trying modafinil (Provigil), a stimulant medication. This option is sometimes used during depressive episodes, but may also perk you up when your meds make you sleepy.

 Modafinil can cause its own side effects, like headache, nausea, dizziness, and diarrhea. But it can also cause anxiety, so you may need to stop taking it during manic episodes.

 Stimulants are generally not recommended if you have heart disease, because they can increase blood pressure or heart rate. Stimulant medications also carry the potential for abuse or dependence, and thus modafinil is a controlled substance.

How to Reduce Your Risk

You can reduce your risk of drowsiness with bipolar medications by adopting these lifestyle habits.

  • Follow excellent sleep hygiene, including a consistent sleep schedule.
  • Get moving if you start to feel bored and sleepy.
  • Manage stress with mindfulness.

  • Eat balanced, nutritious meals.
  • If you take other medications for allergies or colds, choose nondrowsy options.
  • Avoid nicotine, especially before bed.

Brain Fog

Lithium, a common mood stabilizer prescribed for bipolar disorder, works by changing how your brain uses some neurotransmitters (brain messengers) to send signals.

 But these actions can also have negative effects on your brain, like confusion and memory problems (brain fog). Valproate sodium can also cause similar brain changes.

According to research, some people don’t experience these symptoms, and in one study of 88 people, lithium appeared to improve brain function.

 But if you experience brain fog with your bipolar meds, you can adopt lifestyle changes and brain-training exercises to boost your thinking power.

Brain Training

Research suggests that cognitive rehabilitation can improve brain function in people with bipolar disorder. This can include several types of treatments, like psychological therapy, computer-based programs, and even brain stimulation with a mild electrical current or magnets.

Lifestyle Changes

Apart from professional treatments, you can make some lifestyle changes to boost your immune system and decrease inflammation for less brain fog. These include:

  • Following good sleep habits
  • Eating a balanced, nutritious diet
  • Exercising every day
  • Writing down reminders for important information
  • Taking short breaks to give your brain a rest

Uncontrollable Movements

Special nerve cells in your brain make up a system that controls involuntary movements, called the extrapyramidal system.

 Many bipolar medications can cause extrapyramidal (involuntary) movements, which may look like restlessness, muscle stiffness or rigidity (parkinsonism), jerking motions (tardive dyskinesia), pacing, and agitation.

Atypical antipsychotics carry less risk of extrapyramidal side effects compared with older antipsychotics like haloperidol (Haldol).

 Carbamazepine can cause problems with muscle coordination (ataxia), and tremors can emerge while taking valproic acid, lamotrigine, and lithium.

Medication Adjustments

Depending on how severe your symptoms are, your provider may tell you to stop taking your medication or lower your dose. You might need to switch to a medication with a lower risk of extrapyramidal side effects, like olanzapine or quetiapine.

When starting a new bipolar medication, you may need to take an additional drug like benztropine (Cogentin) for the first week, which can help prevent movement-related side effects.

 Your provider may recommend medications targeting specific symptoms, such as the following.

    • Involuntary muscle contractions (tardive dystonia): baclofen (Lioresal, Fleqsuvy), benzodiazepines like alprazolam (Xanax), or injections of botulinum toxin (Botox) to relax your muscles
    • Restlessness (akathisia): beta-blockers like propranolol (Inderal) or 5-HT2A receptor antagonists like cyproheptadine (Periactin), trazodone (Oleptro, Raldesy), or mirtazapine (Remeron)
    • Slow movements, stiffness, and tremors (parkinsonism): amantadine (Gocovri, Osmolex), anticholinergic medications, levodopa (L-dopa), and selegiline (Eldepryl, Zelapar)
    • Involuntary repetitive movements (tardive dyskinesia): valbenazine (Ingrezza) and deutetrabenazine (Austedo)

Talking to Your Doctor

Bipolar medication side effects can feel distressing, but it’s vital to speak to your provider before you make any changes. If you stop a medication suddenly, you could feel an increase in symptoms or trigger a manic episode.

If a change is needed, your provider can help you do it safely. “It is important to discuss [side effects] with the prescribing clinician as soon as possible,” says Dr. Zimbrean. “Prescribers [should] ask about common side effects, but they will not ask the patient about every single possible side effect, so it is important to bring it up if it occurs.”

When you have bipolar disorder, treatment adjustments are a positive thing, says Zimbrean. “[They’re] a sign that treatment is individualized and optimized.”

The Takeaway

  • Bipolar medications improve symptoms of mania and depression, but they can also come with uncomfortable side effects like weight gain, drowsiness, brain fog, and uncontrollable movements.
  • You can manage bipolar medication side effects with lifestyle changes, such as a healthy diet, exercise, and good sleep.
  • If lifestyle changes aren’t enough, your provider can help you adjust your medications, doses, or timing to minimize side effects while still getting the therapeutic benefits.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
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Angela D. Harper, MD

Medical Reviewer
Castle Connolly Top Doctor

Angela D. Harper, MD, is in private practice at Columbia Psychiatric Associates in South Carolina, where she provides evaluations, medication management, and psychotherapy for adults.  

A distinguished fellow of the American Psychiatric Association, Dr. Harper has worked as a psychiatrist throughout her career, serving a large number of patients in various settings, including a psychiatric hospital on the inpatient psychiatric and addiction units, a community mental health center, and a 350-bed nursing home and rehab facility. She has provided legal case consultation for a number of attorneys.

Harper graduated magna cum laude from Furman University with a bachelor's degree and cum laude from the University of South Carolina School of Medicine, where she also completed her residency in adult psychiatry. During residency, she won numerous awards, including the Laughlin Fellowship from the American College of Psychiatrists, the Ginsberg Fellowship from the American Association of Directors of Psychiatric Residency Training, and resident of the year and resident medical student teacher of the year. She was also the member-in-training trustee to the American Psychiatric Association board of trustees during her last two years of residency training.

Harper volunteered for a five-year term on her medical school's admission committee, has given numerous presentations, and has taught medical students and residents. She currently supervises a nurse practitioner. She is passionate about volunteering for the state medical board's medical disciplinary commission, on which she has served since 2015.

She and her husband are avid travelers and have been to over 55 countries and territories.

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Abby McCoy, RN

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Abby McCoy is an experienced registered nurse who has worked with adults and pediatric patients encompassing trauma, orthopedics, home care, transplant, and case management. She is a married mother of four and loves the circus — that is her home! She has family all over the world, and loves to travel as much as possible.

McCoy has written for publications like Remedy Health Media, Sleepopolis, and Expectful. She is passionate about health education and loves using her experience and knowledge in her writing.

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