Mood Stabilisers
Mood stabilisers help manage mood swings in conditions like bipolar disorder and support long-term stability.
Mood stabilisers are medications used to treat mood disorders, particularly bipolar disorder. These medications help reduce the intensity and frequency of mood swings, preventing both manic episodes (periods of elevated mood and energy) and depressive episodes (periods of low mood and energy).
Table of Contents | Jump Ahead
Anticonvulsant Mood Stabilisers
Atypical Antipsychotics as Mood Stabilisers
Serious Side Effects and Monitoring
Finding the Right Mood Stabiliser
Mood Stabilisers and Pregnancy
When Mood Stabilisers Don't Work
What Are Mood Stabilisers?
Mood stabilisers are a class of psychiatric medications that help maintain emotional balance by preventing extreme mood changes. They work by affecting brain chemistry and neural pathways involved in mood regulation, helping you maintain a more stable emotional state.
Key characteristics of mood stabilisers:
- Prevent Mood Episodes: They help prevent both manic and depressive episodes rather than just treating them after they occur.
- Long-Term Treatment: Most people need to take mood stabilisers for extended periods to maintain stability.
- Individual Response: Different people respond better to different mood stabilisers, so finding the right one may take time.
- Regular Monitoring: Many mood stabilisers require regular blood tests to ensure safe and effective levels.
Types of Mood Stabilisers
- Lithium: The oldest and most well-studied mood stabiliser, highly effective for preventing both manic and depressive episodes.
- Anticonvulsants: Originally developed for epilepsy, medications like valproate (Depakote), lamotrigine (Lamictal), and carbamazepine (Tegretol) also stabilise mood.
- Atypical Antipsychotics: Newer medications like quetiapine (Seroquel), aripiprazole (Abilify), and olanzapine (Zyprexa) that can stabilise mood.
- Combination Treatments: Sometimes multiple mood stabilisers are used together for better effectiveness.
What Mood Stabilisers Treat
Primary Conditions- Bipolar I disorder
- Bipolar II disorder
- Cyclothymic disorder
- Schizoaffective disorder
Specific Symptoms
- Manic episodes
- Hypomanic episodes
- Mixed episodes (symptoms of both mania and depression)
- Rapid cycling between mood states
Prevention
- Preventing future mood episodes
- Reducing severity of breakthrough episodes
- Maintaining long-term stability
How Mood Stabilisers Work
- Lithium: Affects multiple neurotransmitter systems and may promote brain cell growth and protection.
- Anticonvulsants: Stabilise electrical activity in the brain and affect neurotransmitter function.
- Atypical Antipsychotics: Block certain dopamine and serotonin receptors while affecting other neurotransmitter systems.
- Overall Effect: All mood stabilisers help regulate brain activity to prevent extreme mood swings.
Benefits of Mood Stabilisers
- Episode Prevention: Significant reduction in the frequency and severity of manic and depressive episodes.
- Improved Functioning: Better ability to maintain relationships, work, and daily responsibilities.
- Quality of Life: Enhanced overall well-being and life satisfaction.
- Reduced Hospitalisation: Fewer emergency situations and psychiatric hospitalisations.
- Long-Term Stability: Sustained mood stability over months and years with proper treatment.
Lithium: The Gold Standard
- Proven Effectiveness: Lithium has the most research support and is considered highly effective for bipolar disorder.
- Suicide Prevention: Unique among mood stabilisers in significantly reducing suicide risk.
- Kidney and Thyroid Monitoring: Requires regular blood tests to monitor kidney and thyroid function.
- Narrow Therapeutic Window: The difference between an effective dose and a toxic dose is relatively small.
- Side Effects: Common side effects include thirst, frequent urination, weight gain, and hand tremor.
Anticonvulsant Mood Stabilisers
- Valproate (Depakote): Effective for manic episodes and mixed states; requires liver function monitoring.
- Lamotrigine (Lamictal): Particularly effective for preventing depressive episodes in bipolar disorder.
- Carbamazepine (Tegretol): Less commonly used due to potential serious side effects and drug interactions.
- Oxcarbazepine (Trileptal): Similar to carbamazepine but with fewer side effects and interactions.
Atypical Antipsychotics as Mood Stabilisers
- Quetiapine (Seroquel): Effective for both manic and depressive episodes; can cause sedation and weight gain.
- Aripiprazole (Abilify): Lower risk of weight gain and metabolic side effects compared to other antipsychotics.
- Olanzapine (Zyprexa): Highly effective but associated with significant weight gain and metabolic changes.
- Lurasidone (Latuda): Approved specifically for bipolar depression with lower weight gain risk.
Starting Mood Stabilisers
- Comprehensive Evaluation: Your doctor will assess your mood history, current symptoms, and medical conditions.
- Baseline Testing: Blood tests, kidney function, liver function, and other tests before starting treatment.
- Gradual Introduction: Most mood stabilisers are started at low doses and gradually increased.
- Monitoring Period: Regular follow-up appointments to track response and adjust dosing.
Common Side Effects
Lithium- Increased thirst and urination
- Weight gain
- Hand tremor
- Nausea and diarrhea
- Thyroid problems (with long-term use)
Anticonvulsants
- Drowsiness and fatigue
- Dizziness
- Weight changes
- Hair loss (valproate)
- Skin rash (lamotrigine)
Atypical Antipsychotics
- Weight gain
- Sedation
- Metabolic changes (diabetes risk)
- Movement side effects (rare)
Serious Side Effects and Monitoring
- Lithium Toxicity: High lithium levels can cause confusion, seizures, and kidney damage.
- Liver Problems: Some anticonvulsants can cause liver damage, requiring regular monitoring.
- Blood Disorders: Rare but serious blood cell problems with some medications.
- Metabolic Syndrome: Weight gain, diabetes, and high cholesterol with some atypical antipsychotics.
Blood Level Monitoring
- Lithium Levels: Regular blood tests to ensure levels are therapeutic but not toxic.
- Anticonvulsant Levels: Monitoring to optimise effectiveness and prevent toxicity.
- Kidney and Liver Function: Regular tests to ensure organs are functioning properly.
- Thyroid Function: Monitoring for thyroid problems, especially with lithium.
Finding the Right Mood Stabiliser
- Individual Response: What works for one person may not work for another.
- Symptom Profile: Different medications may be better for preventing mania vs. depression.
- Side Effect Tolerance: Choosing medications based on which side effects you can best tolerate.
- Medical History: Kidney, liver, or heart problems may influence medication choice.
Mood Stabilisers and Pregnancy
- Planning Ahead: Discuss family planning with your doctor before becoming pregnant.
- Risk-Benefit Analysis: Weighing the risks of untreated bipolar disorder against medication risks.
- Safer Options: Some mood stabilisers are safer during pregnancy than others.
- Specialised Care: Working with specialists experienced in treating pregnant women with bipolar disorder.
Drug Interactions
- Other Medications: Many drugs can affect mood stabiliser levels or increase side effects.
- NSAIDs and Lithium: Pain relievers like ibuprofen can increase lithium levels dangerously.
- Birth Control: Some anticonvulsants can reduce the effectiveness of hormonal contraceptives.
- Supplements: Even vitamins and herbal supplements can interact with mood stabilisers.
Lifestyle Factors
- Consistent Sleep: Maintaining regular sleep patterns is crucial for mood stability.
- Stress Management: Learning to manage stress helps prevent mood episodes.
- Avoiding Triggers: Identifying and avoiding personal triggers for mood episodes.
- Regular Exercise: Physical activity can enhance mood stability and overall health.
Long-Term Treatment
- Maintenance Therapy: Most people with bipolar disorder need long-term mood stabiliser treatment.
- Preventing Relapse: Continuing medication even when feeling well prevents future episodes.
- Regular Monitoring: Ongoing blood tests and medical check-ups to ensure safety.
- Dose Adjustments: Medication levels may need adjustment over time based on response and side effects.
When Mood Stabilisers Don't Work
- Combination Therapy: Using multiple mood stabilisers together for better effectiveness.
- Adjunctive Treatments: Adding antidepressants or other medications during specific episodes.
- Alternative Options: Considering newer medications or different treatment approaches.
- Therapy Addition: Combining medication with psychotherapy for better outcomes.
Stopping Mood Stabilisers
- Medical Supervision: Never stop mood stabilisers without working closely with your doctor.
- Gradual Tapering: Slowly reducing doses over weeks or months to prevent rebound episodes.
- High Relapse Risk: Most people with bipolar disorder will have mood episodes if they stop medication.
- Careful Monitoring: Close observation during and after medication discontinuation.
Emergency Situations
- Lithium Toxicity: Confusion, severe nausea, seizures, or kidney problems require immediate medical attention.
- Severe Side Effects: Serious skin rashes, liver problems, or blood disorders need urgent care.
- Mood Episodes: Severe mania or depression may require hospitalisation despite medication.
- Suicidal Thoughts: Any thoughts of self-harm require immediate professional help.
Questions to Ask Your Doctor
About the Medication- How long will it take to work?
- What side effects should I expect?
- How often will I need blood tests?
- What should I do if I miss a dose?
About Monitoring
- What symptoms should I watch for?
- When should I contact you?
- How will we know if it's working?
- What are the signs of serious side effects?
Cost and Insurance
- Generic Options: Many mood stabilisers are available in less expensive generic forms.
- Insurance Coverage: Most insurance plans cover mood stabilisers, though some may require prior authorisation.
- Patient Assistance: Programs are available to help people afford their medications.
- Long-Term Costs: Consider the cost of regular blood tests and monitoring in addition to medication costs.
Support and Resources
- Healthcare Team: Work with psychiatrists, primary care doctors, and other professionals.
- Family Education: Help family members understand bipolar disorder and treatment.
- Support Groups: Connect with others who have bipolar disorder and understand the challenges.
- Crisis Planning: Develop plans for managing mood episodes and emergencies.
Myths About Mood Stabilisers
"They're Chemical Restraints": Mood stabilisers help restore normal brain function rather than suppressing it."You Should Be Able to Manage Without Them": Bipolar disorder is a medical condition that typically requires medication for effective management.
"They'll Change Your Personality" Proper mood stabiliser treatment helps you feel more like yourself, not different.
"Natural Alternatives Are Just as Good": While lifestyle changes are important, bipolar disorder usually requires medication for stability.
Related Terms
- Bipolar Disorder - Primary condition treated with mood stabilisers
- Lithium - Most well-known mood stabiliser
- Psychiatric Medications - Broader category including mood stabilisers
References
Cleveland Clinic. (2024). Mood Stabilisers: What They Are, How They Work & Side Effects. https://my.clevelandclinic.org/health/articles/mood-stabilizers
PMC/NCBI. (2024). Anticonvulsant drugs in bipolar disorder. https://pmc.ncbi.nlm.nih.gov/articles/PMC3181564/
PMC/NCBI. (2024). Lithium for prevention of mood episodes in bipolar disorders. https://pmc.ncbi.nlm.nih.gov/articles/PMC4272359/
Centre for Addiction and Mental Health. (2024). Mood Stabilising Medications. https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/mood-stabilizing-medication
This information is for educational purposes only and is not a substitute for professional medical advice. Always consult with a qualified healthcare provider before starting, stopping, or changing any medication regimen.
Important:
TherapyRoute does not provide medical advice. All content is for informational purposes and cannot replace consulting a healthcare professional. If you face an emergency, please contact a local emergency service. For immediate emotional support, consider contacting a local helpline.
Find a Therapist
Find skilled psychologists, psychiatrists, and counsellors near you.
