Mood Stabilizers for Bipolar Disorder

Bipolar Medications Library

Mood stabilizers are one of the most important groups of medications for bipolar disorder. Lithium was the first medication used to treat bipolar disorder, and it also can be used as an add-on treatment for clinical depression. Many of the medications now classified as mood stabilizers are drugs called anticonvulsants that were first used to treat seizure disorders. Calcium channel blockers, developed to treat heart-related conditions, are being studied as mood stabilizers.

Mood stabilizers are the primary treatment for mania and hypomania, but some also have antidepressant effects. In addition, there are drugs outside this category that also can help reduce the frequency or severity of manic or hypomanic symptoms.

Lithium - The First Mood Stabilizer

Lithium is a chemical element that was discovered in 1817. In the late 19th century, doctors began to notice that Lithium had mood stabilizing properties while experimenting with it on patients for other conditions. The first paper on Lithium for bipolar disorder was published in 1950, and the element was developed into a form that could be prescribed over the next 20 years, gaining approval from the U.S. Food and Drug Administration in 1970. Today, Lithium remains the only medication that was approved first for bipolar disorder, rather than being developed for other conditions or symptoms and later found to work as a mood stabilizer.

Lithium has antidepressant effects and is an excellent treatment for mania and hypomania. Although it is the oldest mood stabilizer, it is still a staple in the medical arsenal for treating bipolar symptoms.

• The First Mood Stabilizer
• Tests and Toxicity
• Major Precautions and Warnings
• Lithium and Weight Gain
• Lithium Side Effects

Anticonvulsants As Mood Stabilizers

Anticonvulsants are also called anti-epileptic drugs or AEDs and were developed to treat seizure disorders. There are several types of seizures, the most recognized type being grand mal seizures, which are caused by abnormal electrical discharge in the brain.

• Anticonvulsants Used as Mood Stabilizers

Calcium Channel Blockers

There is some evidence that some drugs called calcium channel blockers are effective as mood stabilizers. These drugs are primarily used to treat conditions such as high blood pressure and irregular heartbeats. More and larger studies are needed to determine whether calcium channel blockers will be a permanent addition to the medications used for bipolar disorder.

• Calcium Channel Blockers as Mood Stabilizers

Other Medications as Mood Stabilizers

Antipsychotics
Acute episodes of mania result in psychosis in as many as two-thirds of those with this disorder. Thus, antipsychotics are used frequently in treating bipolar symptoms. They are also often used to decrease symptoms of mania until mood stabilizers such as those listed above can take full effect. In some cases, these may be used for long-term maintenance of stability. Several atypical antipsychotics ('second-generation' drugs) also have antidepressant properties.

• Antipsychotics as Mood Stabilizers

Anti-Anxiety Drugs
Anti-anxiety drugs in a class called benzodiazepines are sometimes used to gain rapid control of manic symptoms so that mood stabilizers have time to take effect. The benzodiazepines are central nervous system (CNS) depressants. These medications are primarily used to produce sedation, induce sleep, relieve anxiety and muscle spasms, and prevent seizures. They may also be used to help restore a normal sleep schedule.

• Benzodiazepines