Mood Stabilizers for Bipolar Disorder

Mood-stabilizing medications like lithium help normalize brain activity in people with bipolar disorder.

Key Takeaways

Mood stabilizers are used along with antidepressants to balance out the extreme highs of bipolar disorder.

Medications for bipolar disorder must be taken long term, yet they carry risks for potentially serious side effects.

Bipolar disorder is often treated with medications referred to as mood stabilizers, such aslithium or Depakote (valproate) and Tegretol(carbamazepine).

These medications can be very effective in treating hypomania or mania and preventing the recurrence of bipolar episodes.

Types of Mood Stabilizers for Bipolar Treatment

Bipolar disorder is different in different people, and a treatment that can help someone else may not work for you, and vice versa.

But in general, mood stabilizers should always be used along with antidepressantsto treat bipolar disorder in order to reduce the risk for mania, according to a 2014 study published in the American Journal of Psychiatry.

Mood-stabilizing medications that your doctor may recommend include:

Lithium. This drug can help balance out the emotional highs and lows of bipolar disorder.

“Lithium has this curious property of working both against mania and depression,” says Gary Sachs, MD, founding director of the Bipolar Clinic and Research Program at Massachusetts General Hospital in Boston and associate clinical professor of psychiatry at Harvard Medical School.

Lithium appears to work by helping to normalize brain activity. It also helps prevent both depression and mania relapses.

Valproate and carbamazepine. Valproate (also called valproic acid) and carbamazepine were first used to treat convulsions in people with epilepsy.

Researchers then found that these drugs could also help treat bipolar disorder symptoms. “Valproic acid and carbamazepine have, in fact, been shown to be efficacious for the treatment of acute mania,” says Dr. Sachs.

The two drugs work by calming the brain, resulting in a better and more stable mood.

RELATED: 7 Ways to Get the Best Bipolar Care

These medications can help with bipolar episodes, especially the rapid-cycling variety in which moods change from mania to depression and back again over a period of hours or days.

Sachs says there is also evidence supporting the use of valproate to help prevent recurrences of bipolar episodes.

However, there’s limited evidence that valproate on its own is very effective as a long-term treatment, according to a 2013 research review by the Cochrane Database of Systematic Reviews.

Combination of medications. Lithium, valproate, and carbamazepine are often used together or in combination with dopamine-blocking medications for a more potent mood-stabilizing effect in bipolar treatment.

Special Considerations With Bipolar Treatment

Lithium is usually preferred for the treatment of bipolar disorder in children and adolescents because the safety of valproate and carbamazepine is still being evaluated in these groups.

For instance, numerous studies indicate that valproate puts girls and women at risk of hormonal abnormalities and polycystic ovary syndrome when the medication is taken before age 20.

In addition, if you are a woman with bipolar disorder you will need to talk with your physician about which medications are least risky to take when trying to conceive, during pregnancy, in the postpartum period, and while nursing.

All medicinal bipolar disorder treatments could harm a developing fetus or a breastfeeding baby, but your doctor may be able to tell you about new bipolar treatments that are thought to be safer during pregnancy and lactation.

Side Effects of Mood Stabilizers

Depending on the medication you are using, your doctor or pharmacist can tell you about side effects you could experience.

In general, lithium is commonly associated with:

  • Drowsiness
  • Weakness
  • Nausea
  • Fatigue
  • Tremor
  • Thirst
  • Frequent urination
  • Weight gain
  • Thyroid problems

Side effects of valproate and carbamazepine commonly include:

  • Gastrointestinal problems
  • Headache
  • Double vision
  • Dizziness
  • Anxiety
  • Confusion
  • Liver problems

Any doctor can prescribe these medications, but it’s a good idea to see apsychiatrist, who’s trained to deal with mental illnesses such as bipolar disorder.

You will probably take these medications over the long term, and you may need to add medications if you have manic or depressive episodes that break through despite the treatment.

People with bipolar disorder usually need more than one medication. Over time, working with your psychiatrist, you can determine which bipolar treatment regimen works best for you.

Follow-Up Care Is Key With Bipolar Disorder

Although there are effective treatments for bipolar disorder, there is no cure. Because it’s a long-term illness, ongoing treatment is needed to control your symptoms.

Even if you are taking your medication as directed by your doctor, you may experience mood changes or lingering symptoms. If you have another mental illness, your treatment for bipolar disorder may also be more complicated.

Working closely and openly with your doctor is key to finding the treatment plan that is most effective for you.

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