What Are Mood Stabilizers?

Table of ContentsView AllTable of ContentsTypes of Mood StabilizersHow They WorkConditions Used ForSide EffectsWarnings and Interactions

Table of ContentsView All

View All

Table of Contents

Types of Mood Stabilizers

How They Work

Conditions Used For

Side Effects

Warnings and Interactions

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Most commonly, mood stabilizers are used to treat those withbipolar disorder. However, they can also be used to treat those withschizoaffective disorder,borderline personality disorder(BPD), and in some instances,depression.

There are currently three main types of drug classes used as mood stabilizers in the United States for various conditions.

Mineral (Lithium)

The exact mechanism of how lithium works as a mood stabilizer is not yet fully known. However, research has suggested that it has to do with targeting the activity of specific enzymes within the neuron.This has the overall impact of decreasing abnormal activity in the brain and is known to reduce suicidal behaviors.

Lithium’s most recognized brand names include Eskalith, Lithobid, and Lithonate.

Common side effectsof lithium include increased thirst and urination, headaches, nausea, diarrhea, dizziness or drowsiness, and changes in appetite.However, with continual usage, some of these may decrease in severity.

Anticonvulsants

Certain anticonvulsants, also referred to as anti-seizure medications, are also used as mood stabilizers. Although they were initially used to treat epilepsy, they were found helpful in treating bipolar disorder due to their ability to calm hyperactivity in the brain.

The most widely known anticonvulsants used as mood stabilizers include:

While Depakote and Tegretol are particularly useful in treating mania, Lamictal has been found to be more effective at treating and preventing depressive symptoms in bipolar disorder. Nevertheless, they’re all found to be very useful in helping to stabilize moods overall.

Anticonvulsant side effects vary depending on the particular agent. Common side effects may include headaches, dry mouth, dizziness and drowsiness, fatigue, and weight gain. However, these may also lessen over time with continual use.

Antipsychotics

For those with bipolar disorder, acute episodes of mania can result in psychosis in up to 53% of individuals.Due to this, antipsychotics are often prescribed for the acute treatment of mania. In addition, the newer category of “atypical” antipsychotics also have mood-stabilizing properties of their own.

The most commonly used antipsychotics for this purpose include:

While atypical antipsychotics are much less likely to causeextrapyramidalside effects (stiffness, tremor, shuffling gate, fixed gaze) than the earlier generation of antipsychotics, they are known to cause other side effects such as drowsiness, blurred vision, weight gain, and metabolic problems.

Hypomania vs. Mania: What’s the Difference?

It is not precisely known how these medications stabilize an individual’s mood. These agents have been found to impact various functions within nerve cells in the brain. This includes modulating enzymes and impacting ion channels, cell membranes, proteins, and receptors.

In turn, these agents influence the excitatory effects of the neurotransmitter glutamate and the inhibitory effect of GABA. It is hypothesized that long-term changes in gene expression, protein concentration, and protein phosphorylation may be the underlying reason for the mood-stabilizing effects of these medications.

In summary, it’s complicated.

What About Electroconvulsive Therapy?

Mood stabilizers are usually used to treat the following conditions:

Bipolar Disorder:

This is the most common use for mood stabilizers and the area where most research into their use is found. As a result, they are commonly prescribed and are an essential aspect of treatment for bipolar disorder. Responses to different types vary from person to person, so various treatment plans are individualized.

Mood stablizers can treat mood episodes and be used for maintenance treatment to prevent the recurrence of these episodes.When combined with coping strategies, healthy lifestyle choices, and therapy, many individuals find their symptoms significantly lessen in severity.

Schizoaffective Disorder:

Borderline Personality Disorder:

Mood stabilizers have been used for those experiencing emotional dysregulation andimpulsivity.

Schizoaffective Disorder and Schizophrenia: What Are the Differences?

Each type of mood stabilizer has its own unique side effects that vary from person to person. Here are some common side effects you can experience:

Many of these side effects may tend to diminish with continual medication use as your body adjusts. However, you should seek medical attention if they begin to interfere with your professional or personal life.

Those who take lithium regularly can sometimes experience a serious condition calledlithium toxicity. The kidneys usually excrete lithium; however, the concentration can rise should this mechanism fail or the intake increases excessively.

In most cases, the signs of this toxicity are easily identified and managed. In addition, healthcare providers regularly monitor lithium concentration levels through routine blood tests.

It is also recommended that those taking lithium ensure they are hydrated to maintain a healthyblood serum level. Long-term lithium usage can also result in chronic kidney disease and thyroid abnormalities, so healthcare providers will also check kidney and thyroid function in conjunction with treatment.

Other mood stabilizers like Tegretol and Depakote also require blood level testing to ensure the serum level remains at a steady concentration. Liver functions and blood counts are generally monitored when using these medications. It is also advised that individuals limit their alcohol usage when using these types of medication due to their ability to increase its effect.

It is also important to note that all antipsychotics carry aBlack box warningdue to their association with increased mortality in elderly patients with dementia.

How Emotion Regulation Skills Promote Stability

15 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ruffalo ML.A brief history of lithium treatment in psychiatry.Prim Care Companion CNS Disord. 2017;19(5):17br02140. doi:10.4088/PCC.17br02140Gould TD, Chen G, Manji HK.Mood stabilizer psychopharmacology.Clin Neurosci Res.2002;2(3–4):193–212. doi:10.1016%2FS1566-2772(02)00044-0Volkmann C, Bschor T, Köhler S.Lithium treatment over the lifespan in bipolar disorders.Front Psychiatry. 2020;11:377. doi:10.3389%2Ffpsyt.2020.00377MedlinePlus.Lithium.Grunze HCR.Anticonvulsants in bipolar disorder.Journal of Mental Health.2010;19(2):127–141. doi:10.3109/09638230903469186Grunze HCR.The effectiveness of anticonvulsants in psychiatric disorders.Dialogues Clin Neurosci. 2008;10(1):77–89. doi:10.31887%2FDCNS.2008.10.1%2FhcrgrunzeBurton CZ, Ryan KA, Kamali M, et al.Psychosis in bipolar disorder: Does it represent a more “severe” illness?Bipolar Disord. 2018;20(1):18–26. doi:10.1111/bdi.12527Muralidharan K, Ali M, Silveira LE, et al.Efficacy of second generation antipsychotics in treating acute mixed episodes in bipolar disorder: A meta-analysis of placebo-controlled trials.J Affect Disord. 2013;150(2):408–414. doi:10.1016/j.jad.2013.04.032Rybakowski JK.Genetic influences on response to mood stabilizers in bipolar disorder.CNS Drugs. 2013;27(3):165–173. doi:10.1007/s40263-013-0040-7National Alliance on Mental Health.Schizoaffective disorder.American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 5th edition, Text Revision (DSM-5-TR); 2022. doi:10.1176/appi.books.9780890425787Belli H, Ural C, Akbudak M.Borderline personality disorder: Bipolarity, mood stabilizers and atypical antipsychotics in treatment.J Clin Med Res. 2012;4(5):301–308. doi:10.4021%2Fjocmr1042wNational Kidney Foundation.Lithium and chronic kidney disease.Mental Illness Research Education and Clinical Center.Facts about mood stabilizers.Maust DT, Kim HM, Seyfried LS, et al.Antipsychotics, other psychotropics, and the risk of death in patients with dementia: Number needed to harm.JAMA Psychiatry. 2015;72(5):438–445. doi:10.1001/jamapsychiatry.2014.3018

15 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ruffalo ML.A brief history of lithium treatment in psychiatry.Prim Care Companion CNS Disord. 2017;19(5):17br02140. doi:10.4088/PCC.17br02140Gould TD, Chen G, Manji HK.Mood stabilizer psychopharmacology.Clin Neurosci Res.2002;2(3–4):193–212. doi:10.1016%2FS1566-2772(02)00044-0Volkmann C, Bschor T, Köhler S.Lithium treatment over the lifespan in bipolar disorders.Front Psychiatry. 2020;11:377. doi:10.3389%2Ffpsyt.2020.00377MedlinePlus.Lithium.Grunze HCR.Anticonvulsants in bipolar disorder.Journal of Mental Health.2010;19(2):127–141. doi:10.3109/09638230903469186Grunze HCR.The effectiveness of anticonvulsants in psychiatric disorders.Dialogues Clin Neurosci. 2008;10(1):77–89. doi:10.31887%2FDCNS.2008.10.1%2FhcrgrunzeBurton CZ, Ryan KA, Kamali M, et al.Psychosis in bipolar disorder: Does it represent a more “severe” illness?Bipolar Disord. 2018;20(1):18–26. doi:10.1111/bdi.12527Muralidharan K, Ali M, Silveira LE, et al.Efficacy of second generation antipsychotics in treating acute mixed episodes in bipolar disorder: A meta-analysis of placebo-controlled trials.J Affect Disord. 2013;150(2):408–414. doi:10.1016/j.jad.2013.04.032Rybakowski JK.Genetic influences on response to mood stabilizers in bipolar disorder.CNS Drugs. 2013;27(3):165–173. doi:10.1007/s40263-013-0040-7National Alliance on Mental Health.Schizoaffective disorder.American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 5th edition, Text Revision (DSM-5-TR); 2022. doi:10.1176/appi.books.9780890425787Belli H, Ural C, Akbudak M.Borderline personality disorder: Bipolarity, mood stabilizers and atypical antipsychotics in treatment.J Clin Med Res. 2012;4(5):301–308. doi:10.4021%2Fjocmr1042wNational Kidney Foundation.Lithium and chronic kidney disease.Mental Illness Research Education and Clinical Center.Facts about mood stabilizers.Maust DT, Kim HM, Seyfried LS, et al.Antipsychotics, other psychotropics, and the risk of death in patients with dementia: Number needed to harm.JAMA Psychiatry. 2015;72(5):438–445. doi:10.1001/jamapsychiatry.2014.3018

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Ruffalo ML.A brief history of lithium treatment in psychiatry.Prim Care Companion CNS Disord. 2017;19(5):17br02140. doi:10.4088/PCC.17br02140Gould TD, Chen G, Manji HK.Mood stabilizer psychopharmacology.Clin Neurosci Res.2002;2(3–4):193–212. doi:10.1016%2FS1566-2772(02)00044-0Volkmann C, Bschor T, Köhler S.Lithium treatment over the lifespan in bipolar disorders.Front Psychiatry. 2020;11:377. doi:10.3389%2Ffpsyt.2020.00377MedlinePlus.Lithium.Grunze HCR.Anticonvulsants in bipolar disorder.Journal of Mental Health.2010;19(2):127–141. doi:10.3109/09638230903469186Grunze HCR.The effectiveness of anticonvulsants in psychiatric disorders.Dialogues Clin Neurosci. 2008;10(1):77–89. doi:10.31887%2FDCNS.2008.10.1%2FhcrgrunzeBurton CZ, Ryan KA, Kamali M, et al.Psychosis in bipolar disorder: Does it represent a more “severe” illness?Bipolar Disord. 2018;20(1):18–26. doi:10.1111/bdi.12527Muralidharan K, Ali M, Silveira LE, et al.Efficacy of second generation antipsychotics in treating acute mixed episodes in bipolar disorder: A meta-analysis of placebo-controlled trials.J Affect Disord. 2013;150(2):408–414. doi:10.1016/j.jad.2013.04.032Rybakowski JK.Genetic influences on response to mood stabilizers in bipolar disorder.CNS Drugs. 2013;27(3):165–173. doi:10.1007/s40263-013-0040-7National Alliance on Mental Health.Schizoaffective disorder.American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 5th edition, Text Revision (DSM-5-TR); 2022. doi:10.1176/appi.books.9780890425787Belli H, Ural C, Akbudak M.Borderline personality disorder: Bipolarity, mood stabilizers and atypical antipsychotics in treatment.J Clin Med Res. 2012;4(5):301–308. doi:10.4021%2Fjocmr1042wNational Kidney Foundation.Lithium and chronic kidney disease.Mental Illness Research Education and Clinical Center.Facts about mood stabilizers.Maust DT, Kim HM, Seyfried LS, et al.Antipsychotics, other psychotropics, and the risk of death in patients with dementia: Number needed to harm.JAMA Psychiatry. 2015;72(5):438–445. doi:10.1001/jamapsychiatry.2014.3018

Ruffalo ML.A brief history of lithium treatment in psychiatry.Prim Care Companion CNS Disord. 2017;19(5):17br02140. doi:10.4088/PCC.17br02140

Gould TD, Chen G, Manji HK.Mood stabilizer psychopharmacology.Clin Neurosci Res.2002;2(3–4):193–212. doi:10.1016%2FS1566-2772(02)00044-0

Volkmann C, Bschor T, Köhler S.Lithium treatment over the lifespan in bipolar disorders.Front Psychiatry. 2020;11:377. doi:10.3389%2Ffpsyt.2020.00377

MedlinePlus.Lithium.

Grunze HCR.Anticonvulsants in bipolar disorder.Journal of Mental Health.2010;19(2):127–141. doi:10.3109/09638230903469186

Grunze HCR.The effectiveness of anticonvulsants in psychiatric disorders.Dialogues Clin Neurosci. 2008;10(1):77–89. doi:10.31887%2FDCNS.2008.10.1%2Fhcrgrunze

Burton CZ, Ryan KA, Kamali M, et al.Psychosis in bipolar disorder: Does it represent a more “severe” illness?Bipolar Disord. 2018;20(1):18–26. doi:10.1111/bdi.12527

Muralidharan K, Ali M, Silveira LE, et al.Efficacy of second generation antipsychotics in treating acute mixed episodes in bipolar disorder: A meta-analysis of placebo-controlled trials.J Affect Disord. 2013;150(2):408–414. doi:10.1016/j.jad.2013.04.032

Rybakowski JK.Genetic influences on response to mood stabilizers in bipolar disorder.CNS Drugs. 2013;27(3):165–173. doi:10.1007/s40263-013-0040-7

National Alliance on Mental Health.Schizoaffective disorder.

American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 5th edition, Text Revision (DSM-5-TR); 2022. doi:10.1176/appi.books.9780890425787

Belli H, Ural C, Akbudak M.Borderline personality disorder: Bipolarity, mood stabilizers and atypical antipsychotics in treatment.J Clin Med Res. 2012;4(5):301–308. doi:10.4021%2Fjocmr1042w

National Kidney Foundation.Lithium and chronic kidney disease.

Mental Illness Research Education and Clinical Center.Facts about mood stabilizers.

Maust DT, Kim HM, Seyfried LS, et al.Antipsychotics, other psychotropics, and the risk of death in patients with dementia: Number needed to harm.JAMA Psychiatry. 2015;72(5):438–445. doi:10.1001/jamapsychiatry.2014.3018

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