Mood stabilizers refer to a class of medications most often used to help manage bipolar disorder, a psychiatric disorder characterized by significant changes in mood that can vary in intensity and duration.

A doctor may prescribe mood stabilizers to help manage immediate symptoms of manic and depressive episodes and to prevent people from experiencing these episodes in the future.

Some mood stabilizers have also been approved by the Food and Drug Administration (FDA) to manage migraine, seizure, and trigeminal neuralgia.

Three main types of mood stabilizers have been approved by the FDA for managing bipolar disorder and other health conditions. These include:

  • lithium
  • atypical antipsychotics
  • anticonvulsants

While mood stabilizers may help manage these conditions, they are only one aspect of a treatment plan. Treatment typically involves a combination of medication, talk therapy, and lifestyle modifications.

This article examines the effectiveness and potential side effects of several types of mood stabilizers currently approved by the FDA.

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Lithium, a type of salt, is considered a first-line mood stabilizer for managing bipolar disorder.

It was approved by the FDA in 1970 for treating manic and depressive episodes in people ages 7 years and older. Manic episodes are periods when a person typically feels very high-spirited and energized. A depressive episode is when a person feels very sad and lacks energy.

Researchers and healthcare professionals also recommend lithium for people who have a higher risk of experiencing suicidal thoughts or behaviors.

Experts are still working to understand the underlying mechanism of action of lithium. It is believed that lithium influences the transportation of sodium within muscle and nerve cells, as well as the activity of certain genes, proteins, and enzymes, thereby stabilizing neurotransmitter pathways.

Despite being the oldest mood stabilizer, it is still considered to be one of the most effective medications for managing bipolar disorder.

Side effects of lithium

Although lithium is widely considered effective, it is associated with several potential side effects that range from mild to severe. Some of these side effects may include:

It’s important for a person taking lithium to see a healthcare professional regularly to monitor symptoms and kidney, liver, and cardiovascular function to prevent long-term complications.

Anticonvulsants are a type of mood-stabilizing drug commonly used for managing seizures or manic episodes in people with bipolar disorder.

Three types of anticonvulsants have been approved by the FDA (year):

These drugs help regulate manic episodes by increasing the effects of some inhibitory neurotransmitters, such as gamma-aminobutyric acid (GABA) and cAMP accumulation. This helps calm the central nervous system and reduce excitement.

A healthcare professional may prescribe an anticonvulsant for managing bipolar disorder if a person has not responded well to lithium or has experienced unpleasant side effects.

Alternatively, a person may take an anticonvulsant drug alongside lithium or other mood stabilizers.

Side effects of anticonvulsants

Like lithium, anticonvulsants are associated with a wide range of potential side effects, including:

Anticonvulsants also have an FDA boxed warning because they may increase the risk of having suicidal thoughts or behaviors.

It’s important for a person to speak with a healthcare professional before taking these medications and regularly have discussions with them about how they are feeling while taking the drugs.

Atypical antipsychotics are a second-generation class of medications used to help manage psychiatric conditions like psychosis, schizophrenia, and bipolar disorder.

Several types of atypical antipsychotic drugs have been approved by the FDA (year) for managing bipolar disorder:

Atypical antipsychotics are a type of dopamine and serotonin receptor antagonist. They block dopamine and serotonin receptors in the brain to lower the levels of these neurotransmitters, thereby reducing symptoms of acute manic and depressive episodes.

Research into the effectiveness of atypical antipsychotic drugs for bipolar disorder is still more limited compared to lithium and anticonvulsants.

Side effects of atypical antipsychotics

Atypical antipsychotics have been associated with a wide range of potential side effects, including:

Like other mood stabilizers, it’s important for a person to speak with a healthcare professional before taking atypical antipsychotics to help prevent long-term complications.

Side effects of mood stabilizers can vary significantly from one person to another. Some people may be at a greater risk of experiencing complications. This may include people who:

  • are pregnant
  • are older than 60 years old
  • have weakened kidney or liver function
  • have a heart condition

It’s important for a person taking mood stabilizers to work closely with a doctor to monitor any side effects.

A person may need to try different drugs or combinations of drugs. The goal is to strike a balance between reducing the symptoms of bipolar disorder and minimizing any unwanted side effects.

Yes, a doctor may prescribe a mood stabilizer to help manage anxiety in people with bipolar disorder.

In some cases, mood stabilizers may help manage anxiety in those without psychiatric conditions if other medications, such as antidepressants, have not been effective.

Some mood stabilizers may be prescribed to children to help manage mood or seizure disorders, but the best type and dosage will depend on many factors. It’s important for a child and their parents or legal guardians to work closely with a pediatrician to limit the risks of long-term side effects.

Mood stabilizers are a common treatment for bipolar disorder and seizures, among other conditions.

Lithium can often reduce the symptoms, and some evidence suggests that other drugs, including more recently developed drugs, can have similar effects.

However, mood stabilizers can also cause significant side effects. When prescribing medication, the doctor’s goal is to find a balance between reducing symptoms of bipolar disorder without causing significant unwanted side effects.