How Do Mood Stabilizers Work?

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Mood stabilizers are medications that help people control and “even out” mood swings such as mania, hypomania, and depression. They work by decreasing abnormal activity in the brain. Although the exact mechanism of action is not fully understood, scientists believe that mood stabilizers influence certain neurotransmitters in the brain (chemicals in the nerve cells) that play a part in causing mood disturbances. For example, anticonvulsants, a type of mood stabilizer, reduce the “excitability” of nerve impulses in the brain.

The clinical effects of lithium were discovered in the 1940s, and since then, it has become a widely used medication. The features of other mood stabilizers were discovered in the 1970s and 1980s. While they don’t “cure” mood swings, they often provide notable relief from the symptoms.

What Do Mood Stabilizers Do?

Doctors use mood stabilizers primarily to treat bipolar disorder, mood swings linked with other mental disorders, and sometimes to enhance the effects of other medications used to treat depression. Because mood stabilizers work to decrease abnormal activity in the brain, they can also be used to treat:

Schizoaffective Disorder
Depressive symptoms of Bipolar Disorder
Impulse control disorders
Some mental illnesses in children

Effects of Mood Stabilizing Medication

Mood stabilizing drugs typically treat the symptoms of bipolar disorder and other mood disorders, although people with other conditions such as schizoaffective disorder may also benefit. The three major uses for mood stabilizers are:

Reducing severe symptoms of mania or depression to a manageable level
Stabilizing mood swings
Preventing symptom relapses and hospitalizations

These medications help decrease associated symptoms such as agitation, sleep problems, hallucinations, and delusions. Even when symptoms are under control, mood stabilizers can help prevent relapses and rehospitalization for individuals with bipolar and schizoaffective disorder.

What Are Different Types of Mood Stabilizers?

Lithium

Lithium is a mood stabilizer commonly used to treat bipolar disorder. It is prescribed as:

Lithium carbonate (Camcolit, Pradel, Liskonum)
Lithium citrate (Li-liquid, Pradel)

Common side effects include nausea, weight gain, slowed thinking, fatigue, and tremor. Serious side effects include vomiting, slurred speech, diarrhea, and confusion.

Anticonvulsants

Some anticonvulsant medications help stabilize mood. These drugs, also referred to as anti-epileptic medications, include:

Carbamazepine (Tegretol)
Lamotrigine (Lamictal)
Valproate (Depakote, Epilim)

Common side effects include fatigue, weight gain, nausea, headache, and lower sex drive. Serious side effects include vomiting, abdominal pain, slurred speech, confusion, fever, jaundice, liver damage, and vision problems.

Antipsychotics

Some antipsychotic medications, also known as neuroleptics, are used as mood stabilizers, particularly for treating bipolar disorder. The National Institute for Health and Care Excellence (NICE) recommends these antipsychotics:

Haloperidol (Dozic, Haldol, Haldol decanoate, Serenace)
Olanzapine (Zalasta, Zyprexa, ZypAdhera)
Quetiapine (Atrolak, Biquelle, Ebesque, Seroquel, Tenprolide, Zaluron)
Risperidone (Risperdal, Risperdal Consta)
Asenapine – also used as a treatment for mania

Common side effects include weight gain, dry mouth, constipation, nausea, and restlessness. Serious side effects include vomiting, low blood pressure, uncontrollable movements (tics and tremors), blurred vision, and low white blood cell count.

Are Antidepressants Mood Stabilizers?

Antidepressants help lift mood during depression, but they are not classified as mood stabilizers. Mood stabilizers and antidepressants are separate types of psychiatric medication, although they may be used together in treatment plans.

Signs You May Need a Mood Stabilizer

People experiencing episodes of mania, hypomania, or depression may need mood-stabilizing medication. Acute episodes require immediate treatment, and long-term treatment may be necessary to prevent recurrence. Signs you may need a mood stabilizer include symptoms of:

Mania

Feeling excited and happy without reason
Rapidly moving from one idea to another
Hearing voices
Irritability
Overconfidence
Fast talking and racing thoughts
Distractibility
Inappropriate familiarity with strangers
Trouble sleeping
Grandiose thinking
Risky behavior, such as excessive spending, substance use, or gambling

Hypomania

Hypomania has similar but milder symptoms compared to mania and requires similar treatment.

Depression

Persistent low mood
Fatigue and low energy
Negative thoughts
Feelings of worthlessness or guilt
Loss of interest in activities
Difficulty concentrating
Irritability
Sleep disturbances
Appetite changes
Weight fluctuations
Suicidal thoughts or actions

What Conditions Do Mood Stabilizers Treat?

Different mood stabilizers treat various mental health issues:

Lithium: Long-term treatment for bipolar disorder and short-term treatment for mania.
Valproate (Depakote, Epilim): Treatment for mania if lithium is ineffective, but not recommended for pregnant women.
Carbamazepine (Tegretol): Treats episodes of mania and mixed states.
Lamotrigine (Lamictal): Offers antidepressant effects and treats severe depression in bipolar disorder.
Antipsychotics (Neuroleptics): Drugs like haloperidol (Haldol), quetiapine (Seroquel), and risperidone (Risperdal) can be used as mood stabilizers for bipolar disorder. Asenapine (Saphris) treats acute mania and schizophrenia associated with bipolar disorder.

Can Mood Stabilizers Treat Anxiety?

Certain anticonvulsants and antipsychotics can treat anxiety, particularly when co-occurring with bipolar disorder:

Valproate (Depakote): Treats panic attacks and other psychiatric problems.
Gabapentin (Neurontin): Treats social anxiety and generalized anxiety disorder (GAD).
Pregabalin (Lyrica): Useful for treating GAD.

Are There Always Side Effects From Mood Stabilizers?

Not everyone will experience side effects from mood stabilizers, and many side effects diminish over time as the body adjusts. Common side effects include:

Rashes or itchy skin
Increased thirst
Frequent urination
Stomach upset
Slurred speech
Blackouts
Blurred vision
Loss of coordination

Contact your doctor immediately if you experience a sudden rash, trouble breathing, sudden pain, muscle stiffness, involuntary movements, confusion, excessive daytime sleepiness, or urinary problems.

How To Reduce Risk or Severity of Side Effects from Mood Stabilizers

You can help reduce the risk or severity of side effects by:

Eating a balanced diet and staying hydrated
Engaging in regular physical activity
Reporting significant weight gain
Limiting caffeine and sodium intake
Reducing or quitting smoking

Adjustments to medication dose and schedule may also help manage side effects. Always consult your doctor for advice.

Can Mood Stabilizers Change Your Personality?

Medications, including mood stabilizers, don’t change your personality. They stabilize your mood by treating your psychiatric condition. Your personality is different from the state of your mood. Personality is always the same but moods can change.

However, there is increasing evidence that attitudes and beliefs are important in predicting a patient’s adherence to medications in depressive and bipolar disorders. In a study of 256 patients, 40 to 80% had incorrect views on the effect of mood stabilizers, with 41.7% believing that mood stabilizers changed their personalities.

Furthermore, patients not taking the medication for bipolar and depressive disorders average 40%. The conclusion was that there is a need to improve knowledge and attitudes toward diagnosis and treatment of mental health disorders such as depression and bipolar disorder, particularly in older patients, who had more incorrect views on the effect of mood stabilizers.

Find Treatment at Montare Behavioral Health

If you suspect a mood disorder in yourself or a loved one, comprehensive mental health treatment is available. Montare Behavioral Health centers throughout Southern California specialize in treating depression, anxiety, trauma, schizoaffective disorder, and bipolar disorder.

Montare Behavioral Health offers both inpatient and outpatient programs, along with specialized treatment programs for seniors, young adults, women, college students, and more. Our goal is to help individuals achieve recovery and live full, authentic lives.