The use of mood stabilizers has had a profound impact on the lives of people with bipolar disorder and several other mental health conditions. Research continues to find effective treatments that include the use of medications as well as talk therapies to support the stabilization needed when living with these conditions.
What are Mood Stabilizers?
Mood stabilizers are a group of medications that, as their name suggests, help to regulate and stabilize a person’s mood.
They are mostly used to treat the symptoms of bipolar disorder, but can also be used in treatment for borderline personality disorder, schizoaffective disorder and depression. There are multiple types of mood stabilizers, but they each have the same general goal of making emotions more stable and moderate.
These medications work by regulating and releasing certain neurotransmitters in the brain, resulting in more even and consistent moods. Neurotransmitters are the body’s chemical messengers. They carry chemical signals from one nerve cell to a target cell in other parts of the body, impacting how an individual feels, thinks and acts.
These drugs do not cure the condition, but help to lessen the severity of the symptoms and prevent future manic and depressive episodes.
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Conditions Treated with Mood Stabilizers
Mood stabilizers are considered the gold standard for the treatment of bipolar disorder because they act by reducing mood swings and the risk of severe manic or depressive episodes. They have also been successful in treating the symptoms of borderline personality disorder, schizoaffective disorder and depression.
Individuals diagnosed with borderline personality disorder or BPD are sometimes prescribed mood stabilizers to help treat the BPD symptoms of severe mood swings and impulsive behavior.
In schizoaffective disorder, they may be used in conjunction with other medications such as antidepressants or antipsychotics to reduce the symptoms of psychosis or mania and reduce the likelihood of triggering manic episodes.
Mood stabilizers can be beneficial in the treatment of depression when used with caution. They are often not the first line of treatment for depression, but may be used as treatment when other medications, such as antidepressants, are not helpful.
FAQs
The use of mood stabilizers is considered safe, however, they require close monitoring by a medical provider to look for complications. It is important to communicate with the prescribing provider regarding any side effects from the medication or when the medication is not effective in treating symptoms.
Mood stabilizers should never be stopped abruptly and should only be stopped done under the direction of a medical provider on a safe tapering schedule.
Bipolar disorder is considered a lifelong condition, therefore, the use of mood stabilizers is often would be a lifelong component of bipolar treatment. For individuals who use mood stabilizers to treat depression, the use of these medications can range from several weeks to several months or years, depending on the severity of the condition.
It’s also important to note that mood stabilizers should never be stopped abruptly. It is safest to work with the prescribing medical provider to come up with a tapering schedule to prevent potential relapse into a depressive or manic state or discontinuation syndrome that could cause brain zaps, mood swings, fatigue, anxiety and insomnia.
The use of mood stabilizers during pregnancy is a decision that must be made between the woman and the provider. As with all medications, the benefits versus risks should be considered.
According to an article by MGH Center for Women’s Mental Health, lithium is considered the safest option during pregnancy. It is still not without risks, though. The use of lithium during the first trimester increases the risk of a cardiac malformation in the fetus called Ebstein’s anomaly.
Mood stabilizers such as carbamazepine carry a 1% risk of neural tube defect and valproic acid use is associated with a 3 to 5% risk of neural tube defects and an increase in other malformations of the heart, limbs and genitals.
Studies also suggest that valproic acid can result in developmental delays or other neurobehavioral problems in children exposed to this medication.
The use of a mood stabilizer for bipolar disorder should be done under the direction of a medical provider or psychiatrist. An assessment should be completed to understand the severity of the symptoms, as well as a thorough medical history and review of current medications.
After this, the provider will determine what medication and dosage is needed to safely treat the symptoms of bipolar disorder and develop a plan that should include the use of therapy to successfully manage moods and support stability.
In most cases, the best course of action is to start at a low dose and taper upward until the desired effect is achieved without any serious side effects.
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Types of Mood Stabilizer Drugs
There are three main types of mood stabilizers: lithium, anticonvulsants and antipsychotics.
Lithium, also known as Eskalith, Lithobid and Lithonat, has been FDA approved to treat bipolar disorder since 1970. It works by balancing the neurotransmitters in the brain that regulate mood, behaviors and thoughts.
While it has been successfully used for decades, lithium is not without risk. Individuals who take this mood stabilizing drug must have routine blood monitoring to assess for toxicity, changes to serum sodium levels and thyroid and kidney function.
Individuals who are taking lithium should monitor for side effects and prevent dehydration, as this can raise the lithium blood levels to dangerous levels.
Anticonvulsants include medications like Valproic Acid or Depakote, Lamotrigine or Lamictal, Carbamazepine or Tegretol, and Oxcarbazepine or Trileptal. These medications were originally developed to treat seizure disorders like epilepsy, however, researchers have discovered that they can also treat the symptoms of bipolar disorder.
Some anticonvulsants work by reducing the excitability of neurons in the brain, lowering the risk of mood swings that contribute to manic or depressive episodes.
Others work by blocking sodium or calcium channels in neurons, which stabilizes electrical activity and prevents the neurons from getting overly excited, lowering the risk of severe mood swings.
As well, other anticonvulsants impact dopamine and glutamate levels and increase GABA levels in the brain. This calms the overactive nerve cells in the body.
Finally, there are antipsychotics such as haloperidol, olanzapine, quetiapine, risperidone and asenapine. These may be used to treat bipolar disorder, especially manic or mixed episodes.
Their use has also been shown to prevent future episodes by regulating the function of brain circuits that control mood, thinking and perception. Some of the newer atypical antipsychotics help individuals avoid reckless or impulsive behaviors associated with mania.
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Risks and Side Effects of Mood Stabilizers
As effective as mood stabilizers have been for numerous people, their use is not without risk and should be closely monitored by medical professionals.
Some medications used to treat bipolar disorder require monitoring health metrics like blood serum levels, blood counts and organ function. These medications should always be taken as directed and should never be stopped abruptly.
The side effects and risks are different for the various types of mood stabilizers, so there are different things to look for, whether you’re taking lithium or anticonvulsants or antidepressants.
Even if taken as prescribed, lithium can have side effects. The most common side effects of lithium include:
- Increased thirst and urination
- Nausea, vomiting or diarrhea
- Weight gain
- Fine tremors of the hands
- Tiredness
- Blurred vision
- Impaired memory
- Difficulty concentrating
- Skin changes, such as acne or dry skin
- Slight muscle weakness
You also have to be careful not to take too much of your lithium because it is possible to overdose. A lithium overdose can have these symptoms:
- Severe nausea and vomiting
- Diarrhea
- Shaking and twitching
- Loss of balance
- Slurred speech
- Double vision
- Weakness
- Hyponatremia (having too few electrolytes)
- Thyroid or kidney function changes
Like lithium, anticonvulsant mood stabilizers can have side effects, too. These can include:
- Dizziness
- Drowsiness
- Blurred vision
- Confusion
- Muscle tremors
- Nausea or vomiting
- Mild cramps
- Increased sensitivity to the sun
- Skin sensitivity and rashes
- Poor coordination
- Headache
In rare cases, anticonvulsant medications can have serious side effects too. These include low blood cell counts or infection. If these occur, work with your doctor to determine the best way to proceed with your treatment.
Of course, antipsychotics aren’t without side effects. You might have common side effects such as:
- Abnormal movements
- Constipation
- Dizziness and sedation
- Drug induced movement disorders
- Dry mouth
- High blood sugar
- High cholesterol
- High levels of a hormone called prolactin
- Painful muscle contractions
- Tardive dyskinesia, or repetitive involuntary movements
- Urinary retention
- Weight gain
Antipsychotics can have some serious side effects as well, either on their own or when they’re combined with other incompatible drugs. In rare cases, they can cause:
- Heart and circulatory problems
- Immune disruption
- Type 2 diabetes
The use of mood stabilizers in the treatment of mental health disorders such as bipolar disorder, schizophrenia, depression and borderline personality disorder has been life changing for people around the world.
Along with talk therapies, it is possible to live a happy, healthy life; all it takes is to reach out and ask for help. You can connect with a mental health provider who can help on Therapy.com.
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