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Mood Stabilizers

NIMH

What are mood stabilizers?

Mood stabilizers are used primarily to treat bipolar disorder, mood swings associated with other mental disorders, and in some cases, to augment the effect of other medications used to treat depression. Lithium, which is aneffective mood stabilizer, is approved for the treatment of mania and the maintenance treatment of bipolar disorder. Mood stabilizers work by decreasing abnormal activity in the brain and are also sometimes used to treat:

  • Depression (usually along with an antidepressant)
  • Schizoaffective Disorder
  • Disorders of impulse control
  • Certain mental illnesses in children

Anticonvulsant medications are also used as mood stabilizers. They were originally developed to treat seizures, but they were found to help control unstable moods as well. One anticonvulsant commonly used as a mood stabilizer is valproic acid (also called divalproex sodium). For some people, especially those with “mixed” symptoms of mania and depression or those with rapid-cycling bipolar disorder, valproic acid may work better than lithium. Other anticonvulsants used as mood stabilizers include:

  • Carbamazepine
  • Lamotrigine
  • Oxcarbazepine

What are the possible side effects of mood stabilizers?

Mood stabilizers can cause several side effects, and some of them may become serious, especially at excessively high blood levels. These side effects include:

  • Itching, rash
  • Excessive thirst
  • Frequent urination
  • Tremor (shakiness) of the hands
  • Nausea and vomiting
  • Slurred speech
  • Fast, slow, irregular, or pounding heartbeat
  • Blackouts
  • Changes in vision
  • Seizures
  • Hallucinations (seeing things or hearing voices that do not exist)
  • Loss of coordination
  • Swelling of the eyes, face, lips, tongue, throat, hands, feet, ankles, or lower legs.

If a person with bipolar disorder is being treated with lithium, he or she should visit the doctor regularly to check the lithium levels his or her blood, and make sure the kidneys and the thyroid are working normally.

Lithium is eliminated from the body through the kidney, so the dose may need to be lowered in older people with reduced kidney function. Also, loss of water from the body, such as through sweating or diarrhea, can cause the lithium level to rise, requiring a temporary lowering of the daily dose. Although kidney functions are checked periodically during lithium treatment, actual damage of the kidney is uncommon in people whose blood levels of lithium have stayed within the therapeutic range.

Mood stabilizers may cause other side effects that are not included in this list.

Some possible side effects linked anticonvulsants (such as valproic acid) include:

  • Drowsiness
  • Dizziness
  • Headache
  • Diarrhea
  • Constipation
  • Changes in appetite
  • Weight changes
  • Back pain
  • Agitation
  • Mood swings
  • Abnormal thinking
  • Uncontrollable shaking of a part of the body
  • Loss of coordination
  • Uncontrollable movements of the eyes
  • Blurred or double vision
  • Ringing in the ears
  • Hair loss

These medications may also:

  • Cause damage to the liver or pancreas, so people taking it should see their doctors regularly
  • Increase testosterone (a male hormone) levels in teenage girls and lead to a condition called polycystic ovarian syndrome (a disease that can affect fertility and make the menstrual cycle become irregular)

Medications for common adult health problems, such as diabetes, high blood pressure, anxiety, and depression may interact badly with anticonvulsants. In this case, a doctor can offer other medication options.