Mood Stabilizers Used to Treat Bipolar Disorder

Multicolored pills on a spoon
David Malan / Photographer's Choice / Getty Images

If you have bipolar disorder, medication will be a key part of your treatment regimen along with therapy, healthy lifestyle choices, and other coping strategies. Mood stabilizers are one of the most important medications for treating bipolar disorder, and they will likely be prescribed to you. These medications control the extreme highs and lows of bipolar disorder, primarily reducing the risk of mania and hypomania, but some mood stabilizers also have antidepressant effects.

Mood Stabilizers

Lithium was the first mood stabilizer used to treat bipolar disorder and it is still used today. Anticonvulsant medications, originally used to treat seizure disorders and eventually found to help stabilize moods, are used for this purpose as well. Other medications, such as antipsychotics and less commonly calcium channel blockers also have mood-stabilizing effects and may be used to treat bipolar disorder.

Lithium: The First Mood Stabilizer

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

If your doctor chooses to prescribe lithium, you will need to have regular blood tests to make sure your lithium blood levels are in a therapeutic range, as levels that are too high can be toxic. Lithium is processed by the kidneys as well as sometimes affecting kidney function, so you will also need your renal function checked while on this medication. Thyroid functions are regularly monitored while you are on lithium. In addition, being dehydrated can cause lithium blood levels to rise, so be sure to drink enough fluids while on lithium.

Anticonvulsants

Anticonvulsants are shown to relieve the symptoms of bipolar disorder. They also called anti-epileptic drugs, as they were developed to treat seizure disorders. A very commonly used anticonvulsant for bipolar disorder is called Depakote (valproic acid).

Antipsychotics

Acute episodes of mania result in psychosis in as many as 50% of those with bipolar disorder. In these people, antipsychotics are used frequently. They are also often used to decrease symptoms of mania until mood stabilizers, such as lithium or valproate, can take full effect. In some people, these medications may be used long-term. Several atypical antipsychotics, the newer generation of antipsychotics, have mood-stabilizing and antidepressant properties.

Calcium Channel Blockers

There is some evidence that certain calcium channel blockers, typically used to treat high blood pressure, irregular heartbeats, and other heart problems can be effective as mood stabilizers.

However, calcium channel blockers must be taken at higher doses and more frequently, up to four to six times daily, in order to be effective for bipolar disorder. They may also be less effective than the first-line medications above.

Benzodiazepines

Anti-anxiety drugs in a class called benzodiazepines are sometimes used to gain rapid control of manic symptoms as mood stabilizers more slowly take effect. The benzodiazepines are central nervous system (CNS) depressants and fast-acting sedatives. These medications are primarily used to induce sleep, relieve anxiety and muscle spasms, and prevent seizures. They may also be used to help restore a normal sleep schedule.

Remember That BPD Medications Take Time to Become Effective

It's important to note that most of these medications, with the exception of fast-acting benzodiazepines, typically take some time to become fully effective. As you wait for your medications to kick in, therapy, exercise, a solid sleep schedule, a good social support network, and a healthy diet can all make a big difference in how you feel.

5 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Rybakowski JK. Genetic influences on response to mood stabilizers in bipolar disorder: current status of knowledge. CNS Drugs. 2013;27(3):165-73. doi:10.1007/s40263-013-0040-7

  2. Won E, Kim YK. An oldie but goodie: Lithium in the treatment of bipolar disorder through neuroprotective and neurotrophic mechanismsInt J Mol Sci. 2017;18(12):2679. doi:10.3390/ijms18122679

  3. Grunze HC. Anticonvulsants in bipolar disorder. J Ment Health. 2010;19(2):127-41. doi:10.3109/09638230903469186

  4. Burton CZ, Ryan KA, Kamali M, et al. Psychosis in bipolar disorder: Does it represent a more "severe" illness?Bipolar Disord. 2018;20(1):18–26. doi:10.1111/bdi.12527

  5. Cipriani A, Saunders K, Attenburrow MJ, et al. A systematic review of calcium channel antagonists in bipolar disorder and some considerations for their future developmentMol Psychiatry. 2016;21(10):1324–1332. doi:10.1038/mp.2016.86

By Marcia Purse
Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing.