4.4.3 Mood Stabilizers
Description
This article is from the Bipolar Disorder FAQ, by barry@webveranda.com (Barry Campbell) with numerous contributions by others.
4.4.3 Mood Stabilizers
Mood stabilizers are the primary treatment for most people. They are
supposed to level your moods, so that you neither get too low
(depressed) or too high (manic). In practice, they work much better
at treating mania than depression, and may have a mood-dampening
effect, so that you get more depressed on a mood stabilizer than you
were before. For this reason, some people are now calling these drugs
"antimanics."
Mood stabilizers take a week or two to get a therapeutic blood level
and then it may take a few more weeks to get the full effect of the
drug. In acute situations, another drug may be needed while you wait
for the mood stabilizer to take effect.
The most common mood stabilizers are:
Lithium (Eskalith, Lithane, Lithobid, Lithonate, Lithotabs)
-----------------------------------------------------------
This is the oldest and most common mood
stabilizer and is usually the first drug you will get
when diagnosed with bipolar disorder. It tends to be
fairly easy to tolerate for most people, and stabilizes
50-60% of patients all by itself.
Common side-effects are: lethargy, diarrhea, nausea,
frequent urination, tremor, weight gain.
Symptoms of lithium toxicity are: intense versions of
the above, twitching, shaking, dizziness, loss of balance,
thirstiness, blurred vision, confusion, convulsions.
Note: if you cannot tolerate the side-effects of regular
lithium, you may want to try a time-released form of it,
such as Lithobid.
It is very important to get frequent blood tests when
first starting lithium because the therapeutic blood
level is quite close to the toxic level. After dosage
is established, blood tests can be every six months.
It is also a good idea to check liver and thyroid function
because these can be damaged by long-term lithium use.
The other mood stabilizers are anticonvulsants, used primarily to
treat epilepsy but also effective in the treatment of Bipolar Disorder:
Valproic Acid (Depakote, Depakene, Epival)
------------------------------------------
Side effects are similar to lithium, long term toxicity may
be less severe. Some people find that Depakote gives them
depression, or intensifies existent depression. It can also
cause sexual dysfunctions (anorgasmia, premature ejaculation,
retrograde ejaculation, reduction of libido) in both men
and women.
Carbamazepine (Tegretol)
------------------------
Tegretol is another anti-convulsant.
Side effects of Tegretol are generally more severe than for
lithium or Depakote, but some patients who cannot tolerate
lithium do fine on Tegretol. Tegretol is also especially
effective for rapid cyclers.
Side effects: nausea, dizziness, confusion, cognitive slowing,
loss of coordination, tremor, sores in mouth & gums,
*reduction in effectiveness of birth control pills.*
Other anticonvulsants are now being used as mood stabilizers
experimentally. Also, Klonopin (an anti-anxiety drug which is also an
anti-convulsant) may be used as a mood stabilizer.
Some people with mood swings who don't actually get fully manic may
get stabilized on an antidepressant alone. (See WARNING below,
however.)
Continue to:
My Books
