Mood stabilizers are psychiatric medications commonly prescribed to people with bipolar disorder and schizoaffective disorder, and borderline personality disorder. These medications help prevent the highs and lows of mood shifts experienced with these disorders. They work by reducing abnormal activity in the brain.
What Are Mood Stabilizers?
Mood stabilizers are psychiatric drugs prescribed to manage and control swings between depression and mania. Generally, mood stabilizers are approved as part of the medication for treating bipolar disorder, mania and hypomania, severe depression, and schizoaffective disorder in some extreme cases. Also, these medications are essential in managing emotional dysregulation, which describes inappropriate reactions that can be viewed as an unacceptable norm of normal emotional responses. Emotional dysregulation can include people who struggle to control their emotional reactions.1
Mood stabilizers work by regulating abnormal activity in the brain. This helps restore critical brain neurochemical activity, which reduces mood swings and prevents manic and depressive episodes. While mood stabilizers can be effective medications for bipolar disorder, the condition can sometimes be challenging to differentiate from other forms of depression. Therefore, if you use antidepressant drugs for managing bipolar, do not use them alone, as they can trigger mania. Also, antidepressant medications such as selective serotonin reuptake inhibitors (SSRIs) can result in mood episodes commonly referred to as rapid cycling. You can lessen the risks by taking a mood stabilizer.
Your doctor may prescribe you mood stabilizers like lithium if you have a manic episode, hypomania, or recurring and severe depression. This also helps to enhance the effects of other drugs used to manage depression. Your doctor may prescribe mood stabilizers for long-term treatment to prevent the acute episode from reoccurring. The best and right mood stabilizer for your condition will only be prescribed after your doctor has understood your symptoms. Mood stabilizers are mostly prescribed for bipolar disorder since the drug may not be effective for all symptoms. Also, the drug does not cause addiction, but long-term use makes your body adjust to the drug, and its absence can result in withdrawal effects.2
Many mood stabilizers are FDA-approved to treat the following conditions*:
Some off-label uses for mood stabilizing drugs can include*:3
- Major depressive disorder (MDD)
- Schizophrenia
- Borderline personality disorder
- Prophylaxis of mood swings
- Post-traumatic stress disorder (PTSD)
*FDA-approved or off-label uses of mood stabilizers can vary by the specific medication. You should reference the prescribing information for a complete list of FDA-approved uses for any medication.
Common Mood Stabilizers
Generally, mood stabilizers are medications effective at treating depression. Mood stabilizer drugs often target the brain’s neurotransmitter systems imbalances, which affect the levels of chemicals such as lithium and valproic acid in the brain. This commonality classified a drug as a mood stabilizer with common mood stabilizers, including lithium minerals, anticonvulsants, and antipsychotics. Before starting your medication, consult your doctor to ensure you are safe on the medication.
When prescribing mood stabilizers, your doctor will consider several factors, including your health and age. Pregnant women and older adults are highly discouraged from using the medication due to the severe risks associated with the medication. Pregnant women using mood stabilizers like anticonvulsants are at high risk of delivering a baby with the fetal anticonvulsant syndrome. Such children with the condition usually have physical defects and delayed development.4 Older adults taking mood stabilizers are more susceptible to the side effects of medication. This prompts for smaller dosages or frequent monitoring by a doctor. Since every person is unique, talk with your doctor to determine the proper treatment for you.
*All medications have a risk of side effects, some of which can be severe. Before starting any medication, you should talk with your doctor about the potential benefits and risks. You should also tell them about any medications, herbs, or supplements you take regularly and share your health history to ensure you take safe medication.
Common mood stabilizers include:
Lithium Minerals
Lithium carries a black box warning, the most serious warning from the FDA for lithium toxicity. This will require that lithium levels are monitored closely while you take medication.5
Lithium is not a manufactured drug but a naturally occurring element that was first discovered in Australian mines in 1871. However, its stabilizing effects were not determined till later in that century. Lithium was first used for mania in the late 1800s. However, there was limited publication regarding the medication for over half a century. The U.S. Food and Drug Administration (FDA) approved its use for treating manic episodes of bipolar disorder and other depressive disorders as well as maintaining bipolar disorder in 1970. It can also be used with other drugs to treat bipolar depression.
Lithium is most commonly used to treat mania which is part of bipolar disorder. It can be used daily to reduce the frequency and severity of manic episodes. Like other medications, lithium minerals have unique chemical structures that can negatively interact with other substances, such as diuretics, non-steroidal anti-inflammatory drugs (NSAIDs), and angiotensin-converting enzyme inhibitors (ACE inhibitors).6 These interactions can be harmful and life-threatening. Therefore, you should take the medication cautiously to prevent further health complications.
Common brand-name medications of lithium include:
- Eskalith
- Lithobid
- Lithonate
- Priadel
Common side effects of lithium include*:
- Nausea
- Diarrhea
- Dry mouth
- Fatigue
- Weight gain
- Mild tremors
- Feeling thirsty
*This is not a comprehensive list of side effects with lithium. There are serious and mild side effects possible with the medication. You should talk with your doctor about your health history and any possible side effects before starting the medication.
Anticonvulsants
Anticonvulsants, also known as antiepileptic medications, are drugs used to treat epilepsy. These drugs suppress the brain’s chemical and electrical activity, contributing to seizures. Antiepileptic drugs are commonly prescribed to manage and prevent episode seizures; hence, they are effective at reducing the frequency and severity of seizures. Also, anticonvulsants can be prescribed to treat other mental health conditions, such as bipolar disorder and neuropathic pain.
Valproic acid and carbamazepine are commonly prescribed anticonvulsants to manage mood swings and regulate the brain’s neurotransmitter activity. Also, anticonvulsants can negatively interact with other medications or substances, such as alcohol, as it increases your risk of drowsiness and motor function impairment. The interaction between anticonvulsants with other drugs negatively affecting the liver can increase the risk of liver damage. Therefore, speaking with your doctor to understand the medications’ potential benefits and risks is essential.
Common anticonvulsant medications include:
- Lamictal
- Carbamazepine
- Oxcarbazepine
- Gabapentin
- Phenytoin
- Valproic acid
Common side effects of anticonvulsants include*:
- Abdominal pain
- Confusion
- Vision problems
- Abnormal bleeding
- Nausea
- Weight gain
- Headache
- Fatigue
- Decreased sexual drive
*This is not a comprehensive list of side effects with anticonvulsants. There are serious and mild side effects possible with these medications. You should talk with your doctor about your health history and any possible side effects before starting the medication.
Antipsychotics
Antipsychotics are only available with a prescription and can be prescribed to treat psychosis. Some antipsychotics are also approved to treat other mental health problems, including schizoaffective disorder, bipolar disorder, and severe depression with symptoms such as psychotic experiences. The medications work by inhibiting dopamine and serotonin, which contribute to the development of mental problems. They can also help contain symptoms such as mania and hallucinations.
Antipsychotics are not always used alone to induce mood stabilization but are sometimes paired with other mood stabilizers. This is because medications are not always considered the first treatment line for bipolar disorder. For example, antipsychotics can be used with mood stabilizers such as lithium or valproic acid, medications used to manage symptoms of bipolar disorder. Like other mood stabilizers, antipsychotics can negatively interact with other medications or substances like alcohol. Possible antipsychotic interaction with a depressant like alcohol can lead to severe side effects, including drowsiness and impaired motor function.
Common antipsychotic medications include:
- Risperidone
- Lurasidone
- Aripiprazole
- Haloperidol
- Olanzapine
- Quetiapine
- Asenapine
- Ziprasidone
Common side effects of antipsychotics include*:
- Light sensitivity
- Tremors
- Rapid heartbeat
- Drowsiness
- Blurred vision.
- Dizziness
- Weight gain
*This is not a comprehensive list of side effects with antipsychotics. There are serious and mild side effects possible with these medications. You should talk with your doctor about your health history and any possible side effects before starting the medication.
Which Mood Stabilizer Is Right For Me?
In order to determine the best medication for your condition, talk to your doctor first. Your physician will conduct some assessment and screening to understand your symptoms better. Also, your doctor will consider other factors before recommending a prescription. These include your health condition (pregnancy) and age (older adults). Such factors will help address safety concerns and ensure you are safe on mood stabilizer medication.
Therefore, your doctor will consider the right mood stabilizer medication based on your symptoms. Every medication should be taken as prescribed to prevent far-reaching side effects that can be life-threatening. If you want to stop your prescription for any reason, talk with your doctor first. Your physician will recommend tapering your dosage for some time. However, if you stop your medication abruptly, you are at increased risk of the medication’s withdrawal effects or return of your symptoms.
Questions to Ask Your Health Team
Before starting your medication, talk with your doctor to understand the risks and benefits of the medications. You can ask your doctor if a mood stabilizer is the best medication for your condition or what are the side effects associated with the drug. Mood stabilizers can raise toxicity levels in your body, leading to a possible overdose. Symptoms of drowsiness, hallucinations and severe headaches characterize this. If you suspect you or someone you know has overdosed on mood stabilizers, call the 9-1-1 emergency number for immediate medical assistance. The overdose can lead to sudden death due to vital body organ failure.
Questions to ask your care team before taking mood stabilizers include:
- What type of mood stabilizer is suitable for my condition?
- What are the side effects of taking mood stabilizers, and how common are they?
- The medications do not work for me. What should I do?
- What will happen if I miss a dose?
- How will I know I have overdosed on the medication?
- Is it safe to take mood stabilizers with other medications or substances like alcohol?
- How often should I come for follow-ups?
- I stopped taking the medication. Should I be worried?
- Are there alternatives to mood stabilizers?
- How long will the mood stabilizer take to effect?
Final Thoughts
Mood stabilizers are effective medications that can be prescribed to manage symptoms of bipolar disorder. These medications are classified into lithium minerals, anticonvulsants, and antipsychotics since they work to restore brain neurochemical imbalance. Taking the medications is also associated with common side effects that are less severe. However, mood stabilizers can negatively interact with other medications or substances, leading to severe side effects such as drowsiness. Therefore, these medications can be extremely helpful in reducing symptoms of bipolar disorder, but it’s important to discuss with your care team whether it’s the right medication for you.
