These include:. Other antidepressants include bupropion Wellbutrin and mirtazapine Remeron. All the formal antidepressants tend to help increase levels of serotonin, norepinephrine, or dopamine. Medications such as Depakote and lithium may be more invasive in that they require consistent blood monitoring and potentially serious side effects. The medications that tend to be less problematic in regard to management and side effects include Neurontin and Topamax.
Proper monitoring and bloodwork are required to ensure safety, though not that often. Each medication should be considered in the context of your condition and how it may interact with your existing regimen. A psychiatrist or other mental health professional who can prescribe medication is the best resource to optimize clinical results and ensure proper use and maintenance for success. Jeff Ditzell is a practicing psychiatrist located in the heart of the financial district in New York City.
He has a clinical focus on adult ADHD, depression, and anxiety. Exercise has many known health benefits, but how does it affect people living with bipolar disorder? We explain its pros and cons, and what you should…. Among them, lurasidone offers a good balance of efficacy and tolerability. Matching the mood stabilizer to the patient is a matter of balancing competing goals.
Each stands out in its own way, whether for tolerability, treatment of comorbidities, or benefits in depression, mania, or the maintenance phase. Together, these four treatments cover lot of ground, but you also need to know how to use them. That is covered in the next installment. His written several books on mood disorders, most recently The Depression and Bipolar Workbook. Is there consensus across international evidence-based guidelines for the management of bipolar disorder?
Acta Psychiatr Scand. Bipolar Disord. Int J Neuropsychopharmacol. Wang D, Osser DN. Mohammad O, Osser DN. The psychopharmacology algorithm project at the Harvard South Shore Program: an algorithm for acute mania. If you have these symptoms, stop taking lithium and see your doctor as soon as possible. Changing the amount of salt you use can also affect lithium levels: avoid switching to low- or no-salt diets. Signs that the amount of lithium in the body is higher than it should be include severe nausea, vomiting and diarrhea, shaking and twitching, loss of balance, slurred speech, double vision and weakness.
If you experience any of these effects, see your doctor as soon as possible. In the meantime, stop taking lithium and drink plenty of fluids. If you cannot reach your doctor and the symptoms do not clear up, go to the nearest hospital emergency department.
The differing names for this anticonvulsant medication reflect the various ways it is formulated. Divalproex and its various forms is used for acute manic episodes.
Brand names include Depakene and Epival. Common side-effects of divalproex include drowsiness, dizziness, nausea and blurred vision. Less common side-effects are vomiting or mild cramps, muscle tremor, mild hair loss, weight gain, bruising or bleeding, liver problems and, for women, changes in the menstrual cycle. Carbamazepine Tegretol is another anticonvulsant.
It is used for mania and mixed states that do not respond to lithium or when the person is irritable or aggressive. Common side-effects of carbamazepine include dizziness, drowsiness, blurred vision, confusion, muscle tremor, nausea, vomiting or mild cramps, increased sensitivity to sun, skin sensitivity and rashes, and poor co-ordination.
A rare but dangerous side-effect of carbamazepine is reduced blood cell counts. People who take this drug should have their blood monitored regularly for this effect.
Soreness of the mouth, gums or throat, mouth ulcers or sores, and fever or flu-like symptoms can be a sign of this effect and should be reported immediately to your doctor. If carbamazepine is the cause of these symptoms, they will go away when the medication is stopped.
Oxcarbazepine Trileptal , a closely related drug, may have less side-effects and drug interactions than carbamazepine, but is not as well studied for bipolar disorder. Lamotrigine Lamictal may be the most effective mood stabilizer for depression in bipolar disorder, but is not as helpful for mania.
The starting dose of lamotrigine should be very low and increased very slowly over four weeks or more. This approach decreases the risk of a severe rash—a potentially dangerous side-effect of this drug. Common side-effects of lamotrigine include fever, dizziness, drowsiness, blurred vision, nausea, vomiting or mild cramps, headache and skin rash.
Although it is rare, a severe skin rash can occur with lamotrigine. Any rashes that begin in the first few weeks of treatment should be reported to your doctor. Brand names available in Canada appear here in brackets.
When you start taking mood stabilizers, it may be two weeks or more before you notice their effect and four to six weeks before they reach their full effect. Once your symptoms are under control, you will be encouraged to continue to take mood stabilizers for at least six months and probably longer. How much longer varies from person to person. Mood stabilizers can help prevent further episodes of mania or depression.
In other words, staying on these medications for the long term can help to keep you well. Going off mood stabilizers, on the other hand, can greatly increase your chances of having another episode. Talk to your doctor if you would like to try this. Drugs that are addictive produce a feeling of euphoria, a strong desire to continue using the drug, and a need to increase the amount used to achieve the same effect.
Mood stabilizers do not have these effects. While mood stabilizers are not addictive, when you take them or any drug over months or years, your body adjusts to the presence of the drug.
If you then stop using the drug, especially if you stop suddenly, the absence of the drug may result in withdrawal effects or in return of symptoms. With mood stabilizers, the withdrawal effects are generally mild; the greatest risk with stopping these drugs is the return of symptoms.
Whether you want to cut down your dose or stop taking a medication, the same rule applies: go slowly. Sudden changes in your dose can greatly increase your risk of having another mood episode. The first step is to ask yourself if this is the right time. Are you feeling well? Is the level of stress in your life manageable? Do you feel supported by your family and friends? If you are not satisfied with his or her reasons, you may want to see another doctor for a second opinion.
If your doctor does agree, he or she will advise you not to skip doses but to reduce your dose gradually over a four to six week period. This process of cutting back will take several months. If you want to stop taking more than one medication, your doctor will usually suggest that you lower the dose of one drug at a time.
Lithium Taking lithium during pregnancy can cause heart problems in the foetus. Lithium should be not be taken when you are pregnant if possible. Valproate Valproate can harm an unborn baby. It can cause birth defects such as:. Lamotrigine NICE guidleines say that you should tell your doctor if you are pregnant and taking lamotrigine.
Antipsychotics NICE guidance recommends antipsychotics that are used as mood stabilisers are better than other mood stabilisers if you are pregnant. NICE guidelines recommed that antipsychotics are used as mood stabilisers whilst breast feeding.
Speak to your doctor about this. Donate Search Menu. About us About us. See our contacts page Looking to contact us? Covid support. Supporting yourself Read more Supporting yourself.
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Get involved. Become a campaigner Sign up today Become a campaigner. Get help now. Advice and information Living with mental illness Medications Mood stabilisers. Mood stabilisers This section gives information about medication that can stabilise the highs and lows of your mood. If you would like more advice or information you can contact our Advice and Information Service by clicking here.
Download Mood stabilisers factsheet. Share: Contact us:. Overview You may get mood swings if you have some mental illnesses, including bipolar disorder previously called manic depression , schizoaffective disorder and personality disorder.
Mood swings can mean that you have high moods mania and low moods depression. If you have a mood disorder, you may be given mood stabilising medication which evens out the highs and the lows of your mood. There are different types of medication that can help stabilise mood. Everyone reacts differently to medication and there can be side effects.
Speak to your doctor about your medication if you have any questions. Need more advice? If you need more advice or information you can contact our Advice and Information Service. Contact us Contact us. About What are mood stabilisers? Such as: spending a lot of money, being more interested in sex, using drugs or alcohol, gambling or making unwise business decisions. Hypomania Hypomania is like mania but you will have milder symptoms.
Depression Symptoms of depression can include: low mood, having less energy and feeling tired, feeling hopeless or negative, feeling guilty, worthless or helpless, being less interested in things you normally like doing or enjoying them less, difficulty concentrating, remembering or making decisions, feeling restless or irritable, sleeping too much or not being able to sleep, feeling more or less hungry than usual, losing or gaining weight, when you do not mean to, and thoughts of death or suicide, or suicide attempts.
Your mood may change quickly between mania and depression. You can find more information about: Bipolar disorder by clicking here.
Schizoaffective disorder by clicking here. Depression by clicking here. Personality disorder by clicking here.
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