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5 Mood Stabilizers for Treating Bipolar Disorder

A cartoon of a woman on mood stabilizers for treating bipolar disorder

Bipolar disorder is a mental health condition characterized by cyclic mood episodes shifting between manic and depressive episodes. During periods of bipolar depression, a person experiences lethargy, apathy, sadness, and hopelessness. Whereas during acute manic episodes, they are abnormally euphoric, upbeat, and energetic. 

Bipolar disorders are lifelong conditions, but the mood shifts associated with them can be managed with psychotherapy and medications. 

Please continue reading to learn about some of the mood-stabilizing medications that are used for the treatment of bipolar disorder.

What are the different types of bipolar disorder?

  • Bipolar I disorder: At least one manic episode followed by many hypomanic episodes, which are less severe than manic episodes; depressive episodes would appear before or after the manic episode.
  • Bipolar II disorder: At least one depressive episode lasting at least 2 weeks and one hypomanic episode lasting about 4 days, but no manic episodes.
  • Bipolar disorder with mixed features: Mixed episodes with the symptoms of a manic episode and major depressive episode together
  • Cyclothymic disorder: This is a mild mood disorder that is similar to bipolar II  disorder and is characterized by rapid cycling or frequent mood episodes shifting from manic highs to depressive lows.  
  • Secondary causes: In some people with bipolar disorder, the condition is caused by drug or alcohol use disorder, or it can be triggered by certain medical conditions such as stroke, multiple sclerosis, or Cushing’s disease.

What medications are used to treat bipolar disorder?

Patients with bipolar disorder tend to have extreme mood swings. They are treated with psychotherapy and prescription medicines to manage the symptoms. Common types of bipolar disorder medications include:

Mood stabilizing medications

These drugs help to reduce mood swings and control the frequency of mood episodes. They are called anticonvulsant mood stabilizers because they are also used to treat seizure disorders. Examples of mood stabilizers used to treat bipolar disorder include lithium carbonate (Lithobid), divalproex sodium (Depakote), valproic acid (Depakote), lamotrigine (Lamictal), and carbamazepine (Tegretol).

Antipsychotic medications

Antipsychotic medications change the way the brain cells use certain neurotransmitters. They are prescribed to bipolar patients when the symptoms of bipolar disorder do not respond to mood-stabilizing medication alone. An antipsychotic drug such as risperidone (Risperdal), olanzapine (Zyprexa), quetiapine (Seroquel), ziprasidone (Geodon), aripiprazole (Abilify), asenapine (Saphris), or lurasidone (Latuda) may be prescribed either alone or in combination with a mood stabilizer.

Antidepressants medications

They are used to manage bipolar depression. However, the use of antidepressants in patients with bipolar disorder can trigger acute mania. Therefore, antidepressant medications are prescribed along with a mood stabilizer or antipsychotic drug. Examples of antidepressant medications include SSRIs (selective-serotonin reuptake inhibitors) like fluoxetine (Prozac), citalopram (Celexa), escitalopram (Lexapro), paroxetine (Paxil), and sertraline (Zoloft).

Combination bipolar medications

The bipolar medication Symbyax is a combination of the antidepressant fluoxetine (Prozac) and the antipsychotic drug olanzapine (Zyprexa). It is used to treat bipolar depression and reduce mood swings.

Anti-anxiety medications

Patients with bipolar disorder may be given short-term anxiety treatments such as benzodiazepines during mood episodes to manage anxiety symptoms and sleep disturbances. Examples of benzodiazepines include diazepam (Valium), alprazolam (Xanax), clonazepam (Klonopin), and lorazepam (Ativan).

What are the top 5 mood stabilizers?

Five commonly prescribed mood stabilizers are: 

  • Lithium carbonate (Lithobid)
  • Topiramate (Topamax)
  • Valproic acid (Depakene, Depakote)
  • Lamotrigine (Lamictal)
  • Carbamazepine (Tegretol)

What is the most commonly used mood stabilizer medication?

Lithium carbonate (Lithobid) is one of the most common mood stabilizer medications used in bipolar disorder treatment. 

What is the best mood stabilizer for bipolar disorder?

Lithium is widely used for long-term treatment of bipolar disorder. This medication is included in the treatment plan of many bipolar patients because it is effective in treating mania. It can reduce how often you get an acute manic episode and also the severity of your manic episodes. 

Lithium can be used for acute treatment of bipolar disorder as well as maintenance treatment. Other positive effects of lithium include treating bipolar depression, lowering the risk of suicide, and improving cognition. Lithium has also been found to lower the risk of developing dementia.

Can you treat bipolar with just a mood stabilizer? 

Mood stabilizers are typically only one part of a comprehensive treatment plan for mood disorders like bipolar. They may be used on their own or in combination with other medications. 

The choice of bipolar medicine depends on a person’s symptoms, along with the individual response to the medicine and tolerability of side effects. Some mood stabilizers are more effective at treating manic episodes, while others are better at managing depressive episodes. If one mood stabilizer does not lead to an improvement in symptoms, your mental health professional may try other mood stabilizers or add antipsychotic medications to the treatment regimen.

How long do people with bipolar disorder have to take mood-stabilizing medicines?

Bipolar disorder is a lifelong condition. This mood disorder requires long-term treatment with prescription drugs (bipolar medicines). Maintenance therapy with mood stabilizing medicine can help prevent a recurrence of symptoms of bipolar disorder. For this reason, many people with bipolar disorder continue on maintenance treatment with mood stabilizers for years or even decades, even if it has been years since they last had manic or depressive episodes. 

What are the side effects of mood stabilizers?

Common adverse effects of the primary treatments for bipolar and related disorders include drowsiness, dizziness, fatigue, restlessness, trembling, blurred vision, dry mouth, dry skin, nausea, vomiting, diarrhea, weight gain, difficulty concentrating, memory problems, and effects on kidney and thyroid function. 

Rarely, more serious side effects can occur, such as lithium toxicity, with signs and symptoms such as nausea, vomiting, fatigue, confusion, agitation, fast heart rate, low blood pressure, seizures, and coma.

What is the best bipolar disorder treatment?

The best bipolar disorder treatment is the one that works for you. Your mental health professional will prescribe medications based on the type of bipolar disorder you have and your symptoms. They will perform a risk-benefit analysis of various treatment guidelines and keep in mind drug interactions with your other medications. If one bipolar medicine does not work for you, they will switch you to another medication or combination of medications.

Remember that in addition to bipolar medications, psychotherapy such as cognitive behavioral therapy (CBT) and interpersonal and social rhythm therapy can play an important role in bipolar treatment by helping you identify thoughts and behavior patterns that trigger bipolar episodes. A healthy diet and regular exercise also play a vital role in managing mental disorders like bipolar disorder.
 

References:

  1. https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5299125/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5854802/
  4. https://www.psychiatrictimes.com/view/top-mood-stabilizers-bipolar-disorder
  5. https://psychcentral.com/bipolar/how-to-deal-with-common-side-effects-of-bipolar-medication#side-effects
  6. https://www.ncbi.nlm.nih.gov/books/NBK499992/#
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4970809/