How Does Chlortalidone Treat Bipolar?

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Looking at the Off-Label Drugs Used to Treat Bipolar

The symptoms of bipolar disorder can feel like an elephant sitting on your chest, its weight slowly crushing you. You struggle at first, but your efforts are futile and perhaps even make you feel worse than before.

Just when you think you’ve tried everything, a glimmer of hope appears – a friend shows up unexpectedly and leads the elephant away by its harness. In the world bipolar depression, that relief can be off-label prescription drugs when all others have failed.

While Chlorthalidone is a prescription medication for high blood pressure and edema, the preliminary evidence shows promise in improving bipolar disorders. While using off-labels are not our go-to practice, we are always open to learning new ways to improve client outcomes.

So, what are the possible ways it works, and how does chlortalidone treat bipolar?

The Catalina Behavioral Health team strives to keep up-to-date on the latest research. This knowledge allows us to provide the latest therapies for our patients.

Please keep reading to learn more about what Chlortalidone is and about other off-label alternatives that show promise in treating Bipolar I Disorder.

What Is Chlortalidone and How Could it Help Bipolar Depression?

Chlortalidone is a diuretic medication. It’s approved as a prescription drug for managing high blood pressure and related fluid retention called edema. It helps the kidneys remove excess salt and water from the body, reducing the blood pressure. This drug is part of the thiazide diuretics family, which includes other common names like hydrochlorothiazide.

Chlortalidone brand names are Hygroton and Thalitone. Controlling hypertension (high blood pressure) helps avoid worsening conditions that can eventually lead to congestive heart failure or a heart attack.

What is Off-Label Drug Use?

The term “off label” refers to situations when doctors try a medication because they believe it can help with medical conditions other than the original intent. It’s like a medical pocket knife – you know it has cutting tools when purchasing it. But you soon discover a tiny screwdriver that comes in pretty handy, as well.

Doctors doing this make the decision based on careful research and weigh the potential benefit of the drug’s characteristics against their possible risk factors. For instance, understanding how Chlortalidone works within the cerebrospinal fluid can help doctors understand how it impacts the central nervous system. Thus, they can investigate potential off-label uses.

A current, famous example of prescribing off label is Ozempic. The FDA approved Ozempic as a Type 2 diabetes medication. But when doctors realized that it had significant weight loss benefits, they began prescribing it to patients who needed to lose weight.

Doctors understand that for some patients, chronic obesity carries a higher risk than losing weight using an off-label medication. They know this by reading peer-reviewed studies and following the results of clinical trials.

Using Chlortalidone for Improving Bipolar Disorders

As mentioned earlier, Chlortalidone works by eliminating fluid retention. That same action also alters electrolyte levels in the body. That may offer some help in managing mood disorders.

Electrolytes are necessary for prefrontal cortex function and good mental health. Cells throughout the body, including the brain, benefit from sodium, potassium, calcium, and magnesium. Sometimes, sodium levels get too high. That leads to imbalances. Flushing the sodium with antihypertensive agents can have positive effects on the other electrolytes and restore their balance.

In this off-label use, Chlortalidone is intended to treat high blood pressure and prevent cardiovascular disease. But it appears to help Bipolar I Depression, particularly helping to soften the transition from mania to the depressive phase.

Taking Chlortalidone for Other Off-Label Uses

Besides its off-label benefits for Bipolar I Disorder, Chlortalidone may help improve other physical health conditions and mental disorders:

Anxiety Disorders

Taking Chlorthalidone can be helpful for controlling some symptoms of anxiety, especially social anxiety. The diuretics that lower blood pressure also reduce the rapid heartbeat and sweating that often accompany anxiety attacks.

Major Depressive Symptoms and Major Depressive Episodes

Electrolyte imbalances impact mood. Stabilizing mood swings is vital for anyone with major depression. While it may not directly improve a depressed mood, its off-label use helps restore electrolytes. It shows best promise when combined with professional counseling.

Adverse Effects of Taking Too Much Chlorthalidone

As with all prescription medications, it’s important to follow the directions offered by your prescribing physician. Overuse of Chlortalidone can lead to the following issues:

Low Blood Pressure

High doses of medications for cardiovascular diseases can lead to low blood pressure. It can result in dizziness or fainting. Another risk, especially for older adults, is the increased risk for falls.

Increased Risk of Hyperglycemia

Overusing this medicine can lead to elevated blood sugar levels. It’s a particular concern for anyone with diabetes. Be sure to discuss this with your doctor before taking your starting dose.

Kidney Problems and Liver Disease

Exceeding the maximum daily dose of this drug or most other medications can strain the kidneys. It is a potential cause of kidney disease. Taking more than the maximum dosage of Chlorthalidone can also lead to hepatoxicity. That’s a type of liver damage and has distinct signs, such as jaundice, dark urine, and abdominal pain.

Common Side Effects

Some of the most frequent side effects include sore throat, thirst, or

Drug Interactions When Mixing Chlorthalidone With Other Drugs

Here are a few possible interactions you may see when taking Chlorthalidone with other common prescriptions medications, especially if you exceed the recommended dose:

• Low Dose Aspirin (used without a prescription to treat mildly elevated blood pressure) – Increased risk of unusual bleeding
• Amlodipine – Can cause blood pressure to dip too low, creating dizziness
• Metoprolol – Increases the chances of bradycardia (slowed heart rate)
• Atorvastatin – Can cause muscle pain or weakness
• Montelukast – Increases risks for low potassium levels
• All beta blockers, calcium channel blockers, and angiotensin converting enzyme ACE inhibitors- Betablockers and the others mentioned can cause blood pressure to become too low when combined with other heart treatments.

Interestingly, you should also avoid orange juice when taking fedicine. That’s because it can lower the efficiency of other enzymes involved in metabolizing drugs. Elevated levels of the medicine used to treat your condition can actually lead to side effects due to this particular citrus interaction.

Most patients taking this off-label oral tablet will not experience any problems, as long as they stick to the lower doses usually prescribed by a healthcare professional.

If you have any adverse reactions to Chlorthalidone, especially when taking it off label or with other medications, don’t take the next dose. Instead, call or connect online with the local poison control center. Depending on your symptoms, they may advise you to go to the nearest emergency room. Emergency physicians will inquire about your medical history and take blood tests to learn the next steps to recover from the adverse effects.

It’s also worth a mention that an allergic reaction is rare. However, allergic reactions are possible, especially in people allergic to sulfa drugs. Be sure to mention any known drug allergies with your doctor and pharmacist before starting and on- or off-label medications.

Other Off-Label Drugs That May help Bipolar Disorder

Besides Chlortalidone, these medications are sometimes prescribed off-label:

• Topiramate/Topamax: An anticonvulsant that may help reduce mood swings in bipolar disorder. It may also help as an add-on treatment for managing schizophrenia.
• Oxcarbazepine/Trileptal: A second anticonvulsant that can potentially slow down rapid mood cycling in bipolar disorder or for those with other disorders similar to it. This medication may also help manage autism spectrum disorders.
• Bupropion/Wellbutrin: Antidepressants that may help manage a major depressive episode.
• Carbamazepine/Tegretrol: Antiepileptic seizure medication that may improve a mood disorder.

Taking these off-label drugs or others like it can have adverse effects on pregnant women and newborns. These medications pass into breast milk, potentially causing dehydration or electrolyte imbalances in both mother and child.

Before taking this oral tablet, or any other medications, be sure to talk about the potential risks with your doctors.

Get Evidence-Based Treatment Support at Catalina

Catalina can support all your mental health needs. Our clients have concerns that include anything from cocaine or alcohol abuse to bipolar and mania.

We’re also experts in safe, proven treatment for dual diagnosis, or having two or more co-occurring disorders. Our team is experienced, certified, and compassionate. Above all, they are here with the goal of supporting your mental health needs.

If you’re ready, we are here to help. Reach out Catalina Behavioral Health today to decrease the impact of bipolar disorder on your life.