Mood stabilizers for bipolar disorder can help you reduce the rapid changes between depression and manic or hypomanic episodes.
If you have bipolar disorder, you can try different medications to find the right type and strength for you. Mood stabilizers are a group of drugs that can help many people with bipolar disorder.
With bipolar disorder, you can experience extreme mood swings that happen quickly. You may feel on top of the world for a while and later have a major depressive episode.
It can make it difficult for your day to day life, maintaining relationships, and managing a career and a family.
People with bipolar disorder may use medications, therapy, lifestyle changes, or a combination of these to manage their condition.
With bipolar disorder, your mood can shift from a high feeling of euphoria, or manic episodes, to low feelings of depression, says Dr. Indra Cidambi, medical director of the Center for Network Therapy in New Jersey.
Additionally, people with bipolar disorder may experience cognitive changes.
“You can spend money irresponsibly during a manic episode, only to regret it later, or [experience thoughts of suicide] during a depressive episode, ”explains Cidambi. “Mood stabilizers work by removing the more extreme extremities of these [rapid changes in mood], allowing you to operate normally.
Mood stabilizers won’t cure bipolar disorder, but they can help balance your moods. This doesn’t mean that you won’t experience different moods throughout the day, but you may be less likely to experience episodes of mania or depression, the kind that can last for days or weeks.
Lithium is the most popular and oldest of the mood stabilizers. It is not clear how lithium works, but it “likely targets the activity of one or more enzymes inside cells,” Cidambi explains.
Some common types of mood stabilizers, with the common brand name, include:
Doctors most often prescribe lithium to treat symptoms of bipolar disorder.
The other drugs above were originally developed to treat seizure disorders, but can treat symptoms of bipolar disorder. They can also treat other conditions, such as borderline personality disorder and migraines.
You can only get a mood stabilizer with a prescription from a licensed healthcare professional, not over the counter.
Three types of mood stabilizers vary in how they treat different mental health issues:
- antiepileptic drug
These classes of mood stabilizers have been evaluated in clinical trials and research. This is why some – but not all – antipsychotic and anti-epileptic drugs are approved by the Food and Drug Administration (FDA) as mood stabilizers.
There are several types of bipolar disorder, including bipolar I disorder and bipolar II disorder.
Mood stabilizers are used to treat both.
- Bipolar I disorder consists of manic episodes and depression and is the condition that many people consider to be bipolar disorder. It is more serious than bipolar II disorder and most people with this type have suffered from major depression.
- In bipolar II disorder, you have cycles of major depression accompanied by a milder form of manic episodes, called hypomanic episodes.
“In bipolar II, it helps to moderate [manic episodes] and depression, ”Cidambi says. “While depression is less of a problem, mood stabilizers can still help with suicidal or other negative thoughts.”
As with many medications, mood stabilizers can have side effects.
Some common side effects you might experience include:
- nausea and vomiting
- weight gain
- hand tremors
- Feeling tired
More serious side effects should be treated immediately. Different medications have their own serious side effects, including:
- Many mood stabilizers can cause suicidal thoughts or actions.
- In rare cases, lamotrigine (Lamictal) can cause Stevens-Johnson syndrome, which causes fever, body aches and a peeling rash. According to experts, it can also cause aseptic meningitis, inflammation of the brain and spinal cord membrane, as well as blood or liver problems.
- Depakote can cause liver problems, bruising, and pancreatitis, according to the National Alliance on Mental Illness (NAMI).
- Carbamazepine can cause low amounts of sodium in the body, according to NAMI.
Yes, you may experience withdrawal symptoms if you stop mood stabilizers because your body has become accustomed to these medications. Although, in most cases, withdrawal symptoms are mild, according to Cidambi.
However, stopping your medication may cause your bipolar disorder symptoms to return.
In some cases, the withdrawal symptoms can be more severe. Stopping Lamictal suddenly may cause seizures or other problems, such as nausea and vomiting, irritability and relapse, depending on the doctor.
Other withdrawal effects of mood stabilizers may include:
- balance problem
- Difficulty sleeping
- difficulty concentrating
- mood swings
- having thoughts of suicide or engaging in self-injurious behavior, or both
- muscular weakness
Mood stabilizing drugs usually need to be reduced gradually. This means that you stop using them gradually decreasing the dose over time. It is a good idea to let a healthcare professional know if you experience any withdrawal effects.
Mood stabilizers are different from antidepressants and can be used with them to treat bipolar disorder.
According to a 2018 study, there is controversy over whether antidepressants are effective in people with bipolar disorder.
The authors of the study agreed that antidepressants work for many people with bipolar disorder, but won’t work for everyone.
Consider talking with your doctor about whether you would benefit from an antidepressant as part of your treatment plan.
Keep these safety considerations in mind when it comes to mood stabilizers.
Interactions with other drugs
If you’re taking other medications while taking a mood stabilizer, it’s a good idea to make sure your healthcare team is aware of it. Some medications can interact with mood stabilizers and cause potentially harmful side effects.
Mood stabilizers during pregnancy
Being on a mood stabilizer during pregnancy can mean being monitored more closely or making adjustments to your treatment plan.
This doesn’t mean you can’t take medication, and it’s often better to take medication than not. Consider talking to your doctor if you are pregnant or plan to become pregnant.
Your provider may recommend that you do not drink alcohol or use substances while you are taking mood stabilizers, as this may increase the sedative effects.
Black box warnings
Black box warnings are included on drug labels and provide information about serious or potentially fatal side effects. Different drugs will have black box warnings. For example:
- Lithium can be toxic in high doses in the blood, a condition experts call lithium toxicity.
- Valproate has black box warnings for liver damage, inflammation of the pancreas, and birth defects, according to NAMI.
- Carbamazepine can cause rashes as well as a higher risk of infection because it can lead to a low number of white blood cells, according to NAMI.
It is a good idea to notify your doctor or call 911 immediately if you take too much of your medication. It may also be a good idea to call the poison control center, who can guide you through the next steps.
Currently, there are no over the counter (OTC) drugs that have been approved by the FDA as mood stabilizers.
However, there are some over-the-counter supplements available that could help relieve symptoms of bipolar disorder, although more research is needed. They understand:
- St. John’s Wort. The
the evidence is contradictoryFind out if this herb helps treat symptoms of depression. It also interacts with several drugs.
- Valerian root. Research is mixed, but some research suggests that valerian root may improve anxiety and sleep issues that many people with bipolar disorder may experience.
- Omega-3 fatty acids. According to a
2015 study, Omega-3 fatty acids found in fish, such as salmon, may help stabilize the mood of depression symptoms. This is believed to be due to the potential anti-inflammatory effects of omega-3s.
If you choose to use a supplement to treat your bipolar disorder, it is a good idea to speak to a healthcare professional before doing so.
Mood stabilizers are a group of drugs that can help you manage the symptoms of bipolar disorder. If you’ve been diagnosed with bipolar disorder, consider asking your doctor to help you plan your medication.
Mood stabilizers can have side effects. If you experience them, do not hesitate to talk to your doctor. They will adjust your medication plan to find the right combination of medication types and doses that will benefit you the most. Living well with bipolar disorder means finding the treatment that’s right for you.