Mood Stabilizers: A List of Common Types and How They Work
Author:
Blossom Editorial
Mood stabilizers are a group of medicines used mainly to treat bipolar disorder. They help even out the extreme highs and lows of mood and can prevent future episodes. This guide explains the main types of mood stabilizers, how they work, and what to expect.
Key Takeaways
Mood stabilizers treat bipolar disorder: They are the main medicines used to manage and prevent the manic and depressive episodes of bipolar disorder; they are sometimes used for other conditions.
There are three main groups: The most common mood stabilizers are lithium, certain anti-seizure medicines, and some second-generation antipsychotics.
Each works differently: Lithium, valproate, lamotrigine, and others have different benefits and side effects, so treatment is tailored to the person and needs regular monitoring.
What Are Mood Stabilizers?
Mood stabilizers are medications that help control the dramatic mood shifts of bipolar disorder. They are used to treat both the manic or high-energy phase and the depressive or low-energy phase of the condition, and to prevent these episodes from coming back.
The term mood stabilizer is a bit of a simplification. These medicines do not completely eliminate mood changes, but they make episodes less frequent and less severe. They work by affecting brain chemicals and signaling that influence mood.
While bipolar disorder is the main reason for prescribing mood stabilizers, providers sometimes use them for other conditions, such as schizoaffective disorder or borderline personality disorder.
What Mood Stabilizers Treat
Beyond bipolar disorder, providers may use mood stabilizers for several related conditions, including:
Bipolar I and bipolar II disorder
Schizoaffective disorder
Borderline personality disorders
Severe, treatment-resistant depression is often treated with an antidepressant
Mood symptoms can sometimes be confused with other conditions. For example, people often ask about the difference between ADHD and bipolar disorder or between PMDD and bipolar disorder, since the symptoms can overlap.
Types of Mood Stabilizers
Mood stabilizers generally fall into three main groups, and each contains specific medicines worth understanding on their own.
Lithium
Lithium is the original mood stabilizer and is still considered a first-line treatment. It was first approved by the FDA in the 1970s and remains a preferred option for managing bipolar I disorder. It is used for acute manic episodes and for long-term maintenance in people aged 7 and older.
Lithium has a narrow therapeutic range, which means the dose that helps and the dose that causes harm are closer, so blood levels must be checked regularly.
Anticonvulsants
Valproate (Valproic Acid and Divalproex)
Valproate, sold under names like Depakote, is an anti-seizure medicine that also works as a mood stabilizer. It is used to manage bipolar disorder, including manic and mixed episodes. Common side effects include weight gain, nausea, tremor, and hair thinning. It requires monitoring of liver function and is generally avoided during pregnancy.
Lamotrigine
Lamotrigine is another anti-seizure medicine used for bipolar disorder. It is FDA-approved for maintenance treatment of bipolar I disorder, meaning it helps prevent future episodes, and it is especially useful for the depressive side of bipolar disorder. It is recommended to start at a low dose and increase slowly because of a rare but serious skin rash.
Carbamazepine
Carbamazepine is an older anti-seizure medicine that also stabilizes mood. It is sometimes used when other options have not worked. It can interact with many other medicines because of how the liver processes it, so providers should review a person's full medication list carefully.
Like some other mood stabilizers, carbamazepine may require blood tests to check drug levels and blood counts during treatment, and it is generally avoided in pregnancy because of risks to the baby.
Second-Generation Antipsychotics
Some newer antipsychotic medicines, such as quetiapine and aripiprazole, are also used to stabilize mood in bipolar disorder. They can treat manic and depressive episodes and are sometimes combined with lithium or valproate. Despite the name, these medicines are used for mood, not only for psychosis.
How Mood Stabilizers Work
Mood stabilizers don't all work in the same way. While researchers are still learning exactly how they work, medications like lithium, valproate, and carbamazepine are thought to help regulate the brain's signaling pathways involved in mood. This helps stabilize mood and reduce the extreme highs and lows seen in conditions like bipolar disorder.
Anti-seizure mood stabilizers are believed to calm overactive electrical signaling in the brain, while antipsychotic mood stabilizers act on dopamine and serotonin systems.
Because each medicine works differently, finding the right one can take time. Providers consider the type of bipolar disorder, whether the main problem is mania or depression, and a person's other health conditions. It is common to try more than one medicine, or a combination, before finding the approach that works best. This is a normal part of treatment rather than a sign that the medicine is failing.
There is no single best mood stabilizer for everyone. The right choice depends on the person and the symptoms that need the most attention. Therapy and healthy daily routines, including steady sleep, are also important parts of treatment. Many people do best with a combination of medication and support rather than medication alone.
If you think a mood disorder may be affecting your life, you can connect with a board-certified psychiatric provider through Blossom Health and start care covered by in-network insurance at joinblossomhealth.com/start.
Monitoring and Side Effects
Mood stabilizers are effective, but they require ongoing monitoring to stay safe.
Lithium needs regular blood tests to check drug levels, kidney function, and thyroid function.
Valproate and carbamazepine need liver function and blood count checks.
Lamotrigine requires a slow dose increase to lower the risk of a serious rash.
Weight changes, tremor, and stomach upset are possible with several of these medicines.
Regular check-ins with a provider are a normal part of taking a mood stabilizer. These visits let your provider catch side effects early, adjust the dose, and make sure the medicine is still the right fit. It helps to tell your provider about any new symptoms, even ones that seem small, since some side effects are easier to manage when they are caught early. Keeping up with blood tests when they are ordered is one of the most important things you can do to stay safe on these medicines.
Managing Your Mood Stabilizer Medication
Finding the right mood stabilizer often takes time, careful monitoring, and regular follow-up. At Blossom Health, our mental health professionals work with you to choose the most appropriate medication, monitor how well it's working, manage side effects, and adjust your treatment when needed. With personalized care and ongoing support, we help you get the most from your treatment while keeping your long-term mental health in focus.
Medical Disclaimer
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or medication. If you are experiencing a mental health crisis, contact the 988 Suicide and Crisis Lifeline by calling or texting 988.
Sources
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StatPearls. Valproic Acid. ncbi.nlm.nih.gov
StatPearls. Lamotrigine. ncbi.nlm.nih.gov
StatPearls. Anticonvulsants Toxicity. ncbi.nlm.nih.gov
Cleveland Clinic. Mood Stabilizers. clevelandclinic.org
National Institute of Mental Health. Bipolar Disorder. nimh.nih.gov
National Institute of Mental Health. Mental Health Medications. nimh.nih.gov
MIRECC/CoE. Facts About Mood Stabilizers. mirecca.va.gov
