Mood stabilizers

These are usually the first choice to treat bipolar disorder. In general, people with bipolar disorder continue treatment with mood stabilizers for years. Lithium (also known as Eskalith or Lithobid) is an effective mood stabilizer. It was the first mood stabilizer approved by the FDA in the 1970’s for treating both manic and depressive episodes. Anticonvulsants are also used as mood stabilizers. They were originally developed to treat seizures, but they also help control moods. Anticonvulsants used as mood stabilizers include:

  • Valproic acid or divalproex sodium (Depakote), approved by the FDA in 1995 for treating mania. It is a popular alternative to lithium. However, young women taking valproic acid face special precautions. See the sidebar, “Should young women take valproic acid?”
  • Lamotrigine (Lamictal), FDA-approved for maintenance treatment of bipolar disorder. It is often effective in treating depressive symptoms.
  • Other anticonvulsant medications, including gabapentin (Neurontin), topiramate (Topamax), and oxcarbazepine (Trileptal).

Valproic acid, lamotrigine, and other anticonvulsant medications have an FDA warning. The warning states that their use may increase the risk of suicidal thoughts and behaviors. People taking anticonvulsant medications for bipolar or other illnesses should be monitored closely for new or worsening symptoms of depression, suicidal thoughts or behavior, or any unusual changes in mood or behavior. If you take any of these medications, do not make any changes to your dosage without talking to your doctor.

Side effects of mood stabilizers

  • Restlessness
  • Dry mouth
  • Bloating or indigestion
  • Acne
  • Unusual discomfort to cold temperatures
  • Joint or muscle pain
  • Brittle nails or hair.

When taking lithium, your doctor should check the levels of lithium in your blood regularly, and will monitor your kidney and thyroid function as well. Lithium treatment may cause low thyroid levels in some people.29 Low thyroid function, called hypothyroidism, has been associated with rapid cycling in some people with bipolar disorder, especially women. Because too much or too little thyroid hormone can lead to mood and energy changes, it is important that your doctor check your thyroid levels carefully. You may need to take thyroid medication, in addition to medications for bipolar disorder, to keep thyroid levels balanced. Common side effects of other mood stabilizing medications include:

  • Drowsiness
  • Dizziness
  • Headache
  • Diarrhea
  • Constipation
  • Heartburn
  • Mood swings
  • Stuffed or runny nose, or other cold-like symptoms.

These medications may also be linked with rare but serious side effects. Talk with your doctor or a pharmacist to make sure you understand signs of serious side effects for the medications you’re taking. If extremely bothersome or unusual side effects occur, tell your doctor as soon as possible.


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