Names of mood stabilizers

Mood Stabilizers as a Treatment for Bipolar Mania

Written by WebMD Editorial Contributors

Which Bipolar Medicine Is Best?

Doctors use many types of drugs to treat bipolar disorder. Some fight the extreme highs of mania and others treat the lows of depression. You might take one drug at a time or a few at the same time.

The best bipolar medicine is the one that works best for you. Work with your doctor to decide on the medication plan that helps you the most.

You may keep taking these medications for years or decades, even if it’s been a long time since your last manic or depressive episode. This is called maintenance therapy and helps prevent recurrence of symptoms.

What Is Mood-Stabilizing Medication?

Mood stabilizers are medicines that treat and prevent highs (mania) and lows (depression). They also help to keep your moods from interfering with work, school, or your social life.

Examples include:

Carbamazepine (Carbatrol, Epitol, Equetro, Tegretol)
Divalproex sodium (Depakote)
Lamotrigine (Lamictal)
Lithium
Valproic acid (Depakene)

Some of these drugs are known as anticonvulsants, which are also used to treat seizure disorders, including carbamazepine, lamotrigine, and valproic acid.

Not all of these drugs have the same effects, though. Some (such as lithium) are better at treating mania. Others (such as lamotrigine) may be more useful for depression.

Keep in mind that the term "mood stabilizer" can be misleading. If you take one, your mood can still change during the day. These medicines treat full episodes of mania or depression that last for several days or weeks at a time.

Other Mood-Stabilizing Medicines

Drugs called antipsychotic medications are also common in bipolar treatment plans. You can take them alone or with mood stabilizers to help with symptoms of mania. These drugs include:

Haloperidol (Haldol)
Loxapine (Loxitane) or loxapine inhaled (Adasuve)

Today, doctors may prescribe newer antipsychotic drugs, including:

Aripiprazole (Abilify)
Asenapine (Saphris)
Cariprazine (Vraylar)
Lumateperone (Caplyta)
Lurasidone (Latuda)
Olanzapine (Zyprexa)
Olanzapine/samidorphan (Lybalvi)
Quetiapine fumarate (Seroquel)
Risperidone (Risperdal)
Ziprasidone (Geodon)

Medicines for Bipolar Depression

Most of the time, doctors will start bipolar disorder treatment by prescribing a mood-stabilizing drug like lithium. But the FDA has approved some medicines for bipolar depression, too:

Fluoxetine combined with olanzapine (Symbyax)
lumateperone (Caplyta)
Lurasidone (Latuda). You might take it alone or with lithium or valproic acid.
Quetiapine fumarate (Seroquel)

For some people, traditional antidepressants may trigger a manic episode. Because of this risk, your doctor should keep track of you closely if you take one.

Will the Medicine Work for Me?

Your doctor can’t predict how well a particular bipolar medication will work for you. You may need to try several different kinds and different doses to figure out the right approach. And that can take time.

It can be frustrating, but don't give up. Eventually, you and your doctor should be able to find a prescription that works for you.

Medication Tips

If you have bipolar disorder, taking your medication should be part of your routine. Take it at the same time every day. It's easier to remember if you do it along with another daily activity, like brushing your teeth, eating breakfast, or getting into bed. A weekly pillbox can help you see if you've missed a dose.

Be sure to talk to your pharmacist or doctor about the best time of day to take your bipolar medications. Some are best if you take them in the morning or at bedtime and others with meals or after meals.

Make sure you know what to do if you accidentally miss a dose. Ask your doctor. Don't assume that doubling up is a good idea.

Side Effects of Bipolar Drugs

Like any drug, bipolar medicines can cause some side effects. They vary depending on which medications you use. These side effects can include:

Nausea
Tremors
Hair loss
Sexual problems
Weight gain
Liver damage
Kidney damage
Diarrhea
Belly pain
Skin reaction

Some medications can affect how well your liver works or the amount of white blood cells or platelets you have. You may need regular tests to make sure that you're staying healthy. The antipsychotic drug ziprasidone (Geodon) is linked to a rare but serious skin reaction called DRESS syndrome (drug reaction with eosinophilia and systemic symptoms).

Many side effects will go away after a few weeks of treatment. If you still feel bad after that, see your doctor. Don't assume you have to just live with the side effects. Your doctor may be able to change your dose, give you another medicine to control the side effects, or try a different medication altogether.

Stick to Your Treatment

Medications for bipolar disorder are powerful drugs, and you must take them exactly as your doctor recommends. Don't stop taking a medicine without your doctor's approval. It can be dangerous.

When you're feeling good, you might decide that you want to stop taking your medication. But that's a bad idea unless your doctor agrees. Treatment only during mood episodes may not be enough to prevent symptoms from coming back. In most people, maintenance treatment between mood episodes makes mania and depression happen less often and makes them less severe. If you're feeling good now, that's likely because your medication is working. So stick with it.

Bipolar Disorder Guide

Overview
Symptoms & Types
Treatment & Prevention
Living & Support

Mood Stabilizers List: Mineral, Anticonvulsants, and Antipsychotics

Medically reviewed by Alan Carter, Pharm.D. — By Scott Frothingham — Updated on September 11, 2018

Mood stabilizers are psychiatric medications that help control swings between depression and mania. They’re prescribed to restore neurochemical balance by decreasing brain activity.

Mood stabilizer drugs are commonly used to treat people with bipolar mood disorder and sometimes people with schizoaffective disorder and borderline personality disorder. In some cases, they’re used to supplement other medications, such as antidepressants, to treat depression.

Medications that are commonly classified as mood stabilizers include:

mineral
anticonvulsants
antipsychotics

Mineral

Lithium is an element that occurs naturally. It is not a manufactured drug.

Lithium was approved by the U.S. Food and Drug Administration in 1970 and is still considered an effective mood stabilizer. It’s approved for the treatment of bipolar mania and the maintenance treatment of bipolar disorder. Sometimes it’s used in combination with other medications to treat bipolar depression.

Because lithium is eliminated from the body through the kidney, during lithium treatments kidney functions should be checked periodically.

Commercial brand names for lithium include:

Eskalith
Lithobid
Lithonate

Side effects from lithium can include:

nausea
fatigue
weight gain
tremor
diarrhea
confusion

Anticonvulsants

Also known as antiepileptic medication, anticonvulsant medications were originally developed to treat seizures. Anticonvulsants that are often used as mood stabilizers include:

valproic acid, also called valproate or divalproex sodium (Depakote, Depakene)
lamotrigine (Lamictal)
carbamazepine (Carbatrol, Tegretol, Epitol, Equetro)

Some anticonvulsants that are used off label — not officially approved for this condition — as mood stabilizers, include:

oxcarbazepine (Oxtellar, Trileptal)
topiramate (Qudexy, Topamax, Trokendi)
gabapentin (Horizant, Neurontin)

Side effects from anticonvulsants can include:

fatigue
headache
weight gain
nausea
abdominal pain
decreased sexual desire
fever
confusion
vision problems
abnormal bruising or bleeding

Note: Off-label drug use means that a drug that’s been approved by the FDA for one purpose is used for a different purpose that has not been approved. However, a doctor can still use the drug for that purpose. This is because the FDA regulates the testing and approval of drugs, but not how doctors use drugs to treat their patients. So, your doctor can prescribe a drug however they think is best for your care. Learn more about off-label prescription drug use.

Antipsychotics

Antipsychotics may be prescribed along with mood stabilizing drugs. In other cases, they seem to assist mood stabilization on their own. Antipsychotics used to treat bipolar disorder include:

aripiprazole (Abilify)
olanzapine (Zyprexa)
risperidone (Risperdal)
lurasidone (Latuda)
quetiapine (Seroquel)
ziprasidone (Geodon)
asenapine (Saphris)

Side effects from antipsychotics can include:

rapid heartbeat
drowsiness
tremors
blurred vision
dizziness
weight gain
sensitivity to sunlight

Mood stabilizer drugs are primarily used to treat people with bipolar mood disorder. If you have mood swings that are affecting your energy, sleep, or judgment, talk to your doctor. If appropriate, your doctor may put together a treatment plan that may include mood stabilizers.

Last medically reviewed on September 7, 2018

How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Mayo Clinic. (2018). Lithium (oral route) description and brand names.
mayoclinic.org/drugs-supplements/lithium-oral-route/description/drg-20064603
Mayo Clinic. (2018). Bipolar disorder.
mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955
National Institute of Mental Health. (n.d.). Mental health medications.
nimh.nih.gov/health/topics/mental-health-medications/index. shtml
Shorter E. (2009). The history of lithium therapy.
ncbi.nlm.nih.gov/pmc/articles/PMC3712976/
U.S. Department of Veterans Affairs. (n.d.). Facts about mood stabilizers.
mirecc.va.gov/visn22/Facts_about_Mood_Stabilizers_Veteran_and_Family_Handout.pdf
U.S. National Library of Medicine. (2017). Lithium: MedlinePlus drug information.
medlineplus.gov/druginfo/meds/a681039.html
U.S. National Library of Medicine. (2017). Oxcarbazepine.
medlineplus.gov/druginfo/meds/a601245.html
U.S. National Library of Medicine. (2017). Valproic acid.
medlineplus.gov/druginfo/meds/a682412.html
U.S. National Library of Medicine. (2017). Topiramate.
medlineplus.gov/druginfo/meds/a697012.html
U.S. National Library of Medicine. (2018). Lamotrigine.
medlineplus.gov/druginfo/meds/a695007.html
U.S. National Library of Medicine. (2018). Carbamazepine.
medlineplus.gov/druginfo/meds/a682237.html

Share this article

Medically reviewed by Alan Carter, Pharm.D. — By Scott Frothingham — Updated on September 11, 2018

Normotimics (mood stabilizers) - DrPsy.ru

Normotimics is a group of drugs that differ in their mechanism of action, common to which is their clinical and pharmacological efficacy, which consists in mood stabilization . They are used both for the treatment of affective disorders and for the prevention of relapse. Normotimics also have the ability to alleviate "sharp corners of character", irritability, quarrelsomeness, irascibility, impulsivity, dysphoria in patients with various mental disorders.

Lithium preparations, carbamazepine derivatives (carbamazepine and oxcarbazepine), valproates, lamotrigine are used as mood stabilizers. Common to these drugs is the need for strict medical monitoring of the patient's condition.
Ideally, blood levels of these drugs should be monitored regularly. An abrupt cessation of taking mood stabilizers can lead to a rapid resumption of affective fluctuations. Given this, the abolition of preventive therapy is carried out gradually, over several weeks.

Basic preparations:

1. Lithium salts.

For many years, lithium salts have been the standard treatment for bipolar disorder and the prevention of flare-ups.

Lithium preparations have been used for quite a long time and are therefore very well studied. A clear relationship was found between the concentration of the drug in blood plasma and its effect (both positive and side effects). In manic-depressive psychosis, lithium preparations are used as a preventive therapy, and, subject to constant monitoring of the lithium content in the blood, it is well tolerated. And with an increase in concentration above a certain level, the dosage is adjusted.

In the absence of such control, the frequency of side effects increases. Main side effects: increased thirst, tremor, nausea, muscle weakness, drowsiness, arrhythmia, changes in thyroid function.

2. Carbazepine derivatives (carbamazepine and oxcarbazepine).

These drugs were originally used as anticonvulsants and for trigeminal neuralgia. Further study showed their effectiveness in the treatment of patients with affective disorders, paroxysmal pain, aggressiveness, behavioral disorders, alcoholism.

The use of these drugs requires regular monitoring of the blood picture, as it can lead to a serious change in the leukocyte formula (agranulocytosis). In addition, it should be remembered that these drugs weaken the concentration of attention, reduce the effectiveness of anticoagulants and hormonal contraceptives.

3. Valproates.

Valproates are anticonvulsants, but recent studies have also proven the effectiveness of these drugs in the treatment and prevention of affective disorders.

The exact mechanism of action of valproic acid in bipolar disorder is unknown, but there is evidence that it increases the synaptic concentration of gamma-aminobutyric acid (GABA), the brain's main inhibitory neurotransmitter.
Mild side effects usually occur at the beginning of therapy and usually resolve on their own. These include gastrointestinal disorders (nausea, vomiting, loss of appetite, heartburn, diarrhea), sedation, tremor. At the beginning of therapy, approximately half of the patients have a sedative effect. With continued use of valproic acid, this effect is reduced. Valproic acid can increase the concentration of cyclic antidepressants, as well as SSRIs, phenobarbital and other drugs.

4. Lamotrigine.

Lamotrigine is a drug originally used to treat epilepsy. Further study revealed its effectiveness in the treatment and prevention of affective disorders (especially depressive ones).

Usually minor side effects, but rash may occur in 10% of patients. Other side effects of lamotrigine include headache, CNS symptoms (diplopia, ataxia, blurred vision), and nausea and vomiting.

Site consultants:

Sergey Bychkovsky

psychotherapist,
gestalt therapist
Maria Goncharova

psychologist,
gestalt therapist
Irina Kornilova

psychotherapist,
psychologist
Konstantin Panin

psychotherapist,
gestalt therapist
Valentina Morozova

psychologist

Need a personal consultation?

Choose the type of session that is convenient for you:

Consultation via voice and video chat (Skype).

Face-to-face consultation with a psychotherapist in St. Petersburg

Face-to-face consultation with a psychologist in Moscow

Normothymics - The Pinel Case

Mood stabilizers are a class of psychotropic drugs commonly used for therapy bipolar affective disorder (BAD). In addition, indications of normotimics are usually used to reduce aggression and irritability, to enhance the effect of antidepressants if they are not effective enough. This explains the use of mood stabilizers in patients without a diagnosis of bipolar disorder: in patients with depression, personality disorders, schizoaffective disorder, or organic brain damage. Normotimics do not always mean BAD, and BAD, in turn, is not always treated with normotimics. Antipsychotics are sometimes used in combination with antidepressants to treat this mental illness. Below we will talk about four mood stabilizers: lithium salts, carbamazepine, valproic acid and lamotrigine.

Lithium carbonate

In Russia, lithium carbonate is the only representative of lithium salts. In the USA, lithium citrate is still used, but in Russia it is not used. Lithium carbonate is used in bipolar and schizoaffective disorder for the relief of manic episodes and as an agent for maintenance therapy. It may also be useful in reducing irritability in patients with psychiatric disorders. The addition of lithium carbonate to antidepressant therapy can enhance their effect, although other methods are currently being used by doctors to overcome the insufficient effect of antidepressants. Another strength of lithium salts is that, according to some data, they can reduce the risk of suicide in patients with depression.

To evaluate the effectiveness and safety of lithium salt therapy abroad, it is customary to evaluate the concentration of lithium ions in the blood. Such an analysis is also available in our country, but it is carried out by private laboratories and at the expense of the patient or his relatives.

Common side effects of lithium preparations are:

hand tremor;
lethargy, memory loss;
skin rash, acne or hair loss;
impaired renal function.

The drug is widely used in the practice of psychiatrists due to its strong and relatively rapidly developing action.

Unlike lithium salts, other mood stabilizers are classified as anticonvulsants, drugs used to treat epilepsy. Examples include valproic acid, carbamazepine and lamotrigine.

Valproic acid

Valproic acid is usually taken in the form of sodium salts - sodium valproate. This compound itself is unique in psychiatry in that it does not contain a cyclic part of carbon and other atoms. Valproic acid is widely used in various types of epilepsy, but it also found a place in psychiatry. The main indication is BAR. Valproic acid and its salts are used to treat the manic phase of bipolar disorder and for maintenance therapy in this disease. A number of researchers believe that valproic acid may be particularly effective in rapid phase changes and in mixed states within the framework of bipolar disorder.

A separate area of use of valproic acid is the suppression and prevention of aggression, emotional instability, impulsivity and self-harm, which can be useful in borderline personality disorder. Valproic acid is also used to enhance the effect of antipsychotics.

The main side effects of valproic acid that usually lead to discontinuation of the drug are

weight gain;
digestive problems (nausea, vomiting, diarrhea and cramps) - these adverse events are usually dose-dependent: the higher the dose of the drug taken, the greater the severity of side effects;
drowsiness and lethargy;
liver damage.

Recently, there has been a lot of discussion among doctors about the harm of valproic acid to the fetus if the mother takes valproic acid during pregnancy. It must be said that other mood stabilizers do not have any advantage in this respect over valproic acid.

Carbamazepine

Carbamazepine is widely loved by neurologists, psychiatrists and narcologists. Various neuralgia, bipolar disorder, mood disorders due to damage to the central nervous system, alcohol dependence and withdrawal syndrome, and so on and so forth. Carbamazepine is dear to the hearts of many specialists and is prescribed for a variety of conditions. It should be taken into account that carbamazepine reduces the concentration of antipsychotics (neuroleptics) and antidepressants in the patient's blood, which can lead to a deterioration in the condition when carbamazepine is added. Like other mood stabilizers, carbamazepine is prescribed for aggression and impulsivity, if they occur with a mental disorder.

Side effects of carbamazepine:

weakness, lethargy;
nausea;
dizziness;
skin rash;
decrease in the number of leukocytes in the blood (especially at the beginning of therapy).
Learn more