Certain mental health conditions can cause extreme high and low moods or rapid mood swings. Bipolar disorder is one of the most well-known examples; schizoaffective disorder can have similar effects. People with these conditions may experience manic, hypomanic, depressive or mixed mood states.
Manic episodes typically last at least a week or up to several months. During these episodes, people often have extremely high energy and grandiose or invincible self-perceptions, and they don’t get as much sleep as they usually do. They may engage in risky behavior or make poor decisions. Hypomanic episodes are shorter, slightly less intense mood episodes.
Mood stabilizers are medications that help mitigate these extremes. They’re also sometimes used in combination with other medications to treat severe depression.
In this blog post, we’ll talk about the most common types of mood stabilizing medications, what conditions they treat and how they work.
What are mood stabilizing medications and how do they work?
Mood stabilizers are medications that help reduce intense mood states and slow down rapid mood swings. Most mood stabilizers regulate certain neurotransmitters and reduce abnormal activity in parts of the brain that may be overstimulated. Anticonvulsants are a type of mood stabilizer that makes nerves in the brain less excitable.
Both mood stabilizers and antidepressants affect neurotransmitters like serotonin, norepinephrine and gamma-aminobutyric acid (GABA). However, they work a bit differently. Mood stabilizers balance levels of neurotransmitters, and most antidepressants increase the availability of certain neurotransmitters by inhibiting transporters that reabsorb them. In people with bipolar disorder, antidepressants can speed up mood cycling or make mood episodes more intense. It’s critical for people who experience mania, hypomania or mixed mood states to talk with a psychiatrist to get an accurate diagnosis before taking any psychiatric medication.
Lithium
Lithium is a naturally occurring mineral that has been used as a mood stabilizer since the mid-1800s. It was approved by the Food and Drug Administration (FDA) for use as a mood stabilizer in 1970. The lithium-based medications available today are actually lithium salt compounds. Researchers aren’t sure exactly how lithium works as a mood stabilizer. They have observed numerous effects on signaling pathways and cellular processes.
Too much lithium in the body can be dangerous, so your prescriber should do blood tests regularly. It can also affect the way your body absorbs salt, so people who take lithium should maintain a consistent sodium intake. Sudden changes in sodium levels can affect lithium concentrations in the blood.
Brand names for medications that contain lithium include:
- Eskalith
- Lithobid
- Lithonate
Some potential side effects of lithium include:
- Thirst
- Dry mouth or metallic taste
- Weight gain
- Nausea or vomiting
- Tremor or shaking
- Frequent urination
- Headaches
- Feeling sleepy or tired
- Diarrhea
- Thyroid problems
- Acne
- Rash
The following are symptoms of lithium toxicity that require prompt medical attention:
- Confusion or memory problems
- Blurred vision
- Drowsiness or loss of consciousness
- Slurred speech
- Problems with coordination, reflexes or involuntary movements
- Fast, slow or irregular heartbeat
- Muscle weakness
- Feeling very thirsty
- Frequent urination
- Diarrhea
- Nausea
Anticonvulsant medications
Anticonvulsants primarily prevent seizures by slowing down certain types of electrical activity in the brain. They’re also sometimes used as mood stabilizers. In the long term, some anticonvulsants can cause serious side effects like osteoporosis or a rare but serious skin rash called Stevens-Johnson syndrome. Your prescriber may recommend calcium or vitamin D supplements. Anticonvulsant toxicity can occur if you take too much of your medication.
Some examples of anticonvulsant medications that function as mood stabilizers include:
- Carbamazepine (Carbatrol, Tegretol, Epitol or Equetro)
- Lamotrigine (Lamictal)
- Valproic acid, known as valproate or divalproex sodium (Depakote or Depakene)
The following anticonvulsants haven’t been approved for use as mood stabilizers by the FDA, but they may be used “off-label” for this purpose:
- Gabapentin (Horizant or Neurontin)
- Oxcarbazepine (Oxtellar or Trileptal)
- Topiramate (Qudexy, Topamax or Trokendi)
Some potential side effects of these anticonvulsants include:
- Fatigue
- Headache
- Nausea
- Abdominal pain
- Decreased sex drive
- Fever
- Confusion
- Blurred vision
- Abnormal bruising or bleeding
- Weight gain or loss
Antipsychotic medications
Antipsychotics work by regulating circuits in the brain that control moods, thinking and perception. They do this by blocking dopamine receptors or working as partial dopamine agonists to stabilize dopamine activity.
Some examples of antipsychotic medications that function as mood stabilizers include:
- Aripiprazole (Abilify)
- Asenapine (Saphris)
- Lurasidone (Latuda)
- Olanzapine (Zyprexa)
- Risperidone (Risperdal)
- Quetiapine (Seroquel)
- Ziprasidone (Geodon)
Some potential side effects of these antipsychotics include:
- Rapid heartbeat
- Drowsiness
- Tremors
- Blurred vision
- Dizziness
- Weight gain
- Sensitivity to sunlight
- Increased blood sugar levels
- Elevated cholesterol (which can increase the risk of diabetes and heart disease)
- Involuntary movements
If you experience extreme mood episodes, you’ll likely need medication to help you manage your moods. It usually takes some time to find a mood stabilizer that works for you. Be sure to tell your prescriber about any medical conditions you have, any medications or supplements you’re taking, and all of the symptoms you’re experiencing. Certain mood stabilizers can make medical conditions worse, and they all have risks of drug interactions.
When you first start taking a mood stabilizer, it may take several weeks to start working. Most side effects are mild, and they should go away as your body adjusts to the medication. You should see a psychiatrist regularly for medication management. Tell them about any side effects right away. You should also talk with your prescriber anytime you want to discontinue or change a mood stabilizer. They don’t have a risk of dependence, but stopping abruptly can have negative effects.
At Lightfully, we help people recover from mood episodes and build a foundation for long-term mental wellness. We create personalized treatment plans for each of our clients, combining medication with individual, group and family therapies. Our facilities offer a supportive, calm and safe environment where you can focus on caring for your mental health while one of our staff psychiatrists helps you find the right medication.
Are you exploring treatment for your mood episodes? We can help. Contact us or reach out to our Admissions Concierge Team.
