Mood stabilizers, described below, are highly effective in stabilizing and maintaining a remission of manic symptoms.
- Valproate or Valproic Acid (Depakote)
- Carbamazepine (Tegretol)
- Gabapentin (Neurontin)
- Topiramate (Topamax)
- Oxcarbazepine (Trileptal)
- Lamotigrine (Lamictal)
Are all mood stabilizers antipsychotics?
Most U.S. psychiatrists use combination therapies for bipolar disorder, particularly when treating acute manic states. The most common combination is a “known” mood stabilizer—such as lithium or divalproex—plus an antipsychotic to quickly control mania.
Wellbutrin, (generic name bupropion), can be considered a “helping hands” medication if someone with bipolar disorder is taking a mood stabilizer and exhibits mainly anti-manic signs. Wellbutrin does NOT cause these side effects.
Starting an antidepressant (a common medication approach for anxiety disorders) before mood stabilization is achieved may worsen the bipolar disorder symptoms. However, an antidepressant can trigger manic episodes, even while taking a mood stabilizer.
They're often used to control mania before mood stabilizers take effect. They can also treat sleeplessness. Additionally, they may help relieve anxiety, which is frequently experienced by people with bipolar depression. Xanax is one of the newer entries in the tranquilizer lineup, and it's the most commonly prescribed.
Sometimes treatment with two or more medications is necessary for children and adolescents who have bipolar disorder and ADHD. For some children, when a mood stabilizer helps only in part and there continue to be problems with impulsivity and revved up behaviors, the addition of an atypical antipsychotic is effective.
However, with some exceptions, especially OCD, caution should be exercised in use of antidepressants, and the use of other agents, such as benzodiazepines or gabapentin, is preferable. Furthermore, anxiety symptoms often improve when mood symptoms are adequately treated with mood stabilizers in bipolar disorder.
Which Benzodiazepines Are Used for Anxiety?
- Xanax or Niravam (alprazolam)
- Klonopin (clonazepam)
- Ativan (lorazepam)
- Valium (diazepam)
- Low risk of weight gain: Lamotrigine (Lamictal) is most likely to cause weight loss.
- Risk of weight gain: Valproate is likely to cause weight gain.
- High risk of weight gain: Lithium is known for causing weight gain.
- Low risk of weight gain: Lurasidone has a low risk of weight gain.
Aripiprazole can be effective in treating the acute manic episodes of bipolar disorder in adults, adolescents and children. However, its effect is only useful for the manic phases with little or no effect on the depressive phases. For this reason, aripiprazole is often used in conjunction with mood stabilizers.
Many of the most prescribed bipolar medications today are NOT mood stabilizers. Instead they address ONLY depression OR ONLY mania. Studies indicate it is best for prevention of mania – BUT lithium is now known to be a WEAK treatment for bipolar depression.
Some of these medications can increase your appetite or cause changes in metabolism leading to weight gain. Whether a certain medication will cause weight gain or other side effects varies from person to person. Medications for bipolar disorder include mood stabilizers, antipsychotics and antidepressants.
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.
Research is limited, but it does appear that mood stabilizers can treat some BPD symptoms effectively. The most-studied medication is lithium. Most of those studies focused on the treatment of impulsivity, but one study showed that lithium can be effective in treating BPD anger and irritation.
Aripiprazole is a medication that works in the brain to treat schizophrenia. It is also known as a second generation antipsychotic (SGA) or atypical antipsychotic. Aripiprazole rebalances dopamine and serotonin to improve thinking, mood, and behavior. Aripiprazole may help some or all of these symptoms.
Zoloft side effects. Zoloft is effective in treating depression, but it can have some side effects. If you have bipolar disorder and you're taking an antidepressant, such as Zoloft, without a mood stabilizer, you may be at risk for shifting into a manic or hypomanic episode.
It is also called manic-depressive illness or manic depression. Children with bipolar disorder go through unusual mood changes. Sometimes they feel very happy or “up,” and are much more energetic and active than usual, or than other kids their age.
Lamotrigine (Lamictal) for Bipolar Disorder. Lamictal is considered a mood-stabilizing anticonvulsant and is most commonly prescribed to prevent or control seizures in the treatment of epilepsy. Recent studies have shown it may possess antidepressant effects in bipolar disorder.
The National Institute of Mental Health says “Antidepressants can make bipolar disorder worse or trigger a manic episode. Try mood stabilizers first and never take antidepressants without them, as antidepressants can trigger mania and rapid mood cycling when used on their own.”
These can include SSRIs such as Prozac, SNRIs such as Effexor, and other well known antidepressants such as Wellbutrin. The key point is that these conventional antidepressants should not be used to treat bipolar depression unless used in combination with a med that is a mood stabilizer or an anti-manic agent.
The 5 individual drugs that can be used as mood stabilisers are:
- lithium (Camcolit, Liskonum, Priadel, Lithonate, Litarex, Li-liquid)
- carbamazepine (Tegretol)
- lamotrigine (Lamictal)
- valproate (Depakote, Epilim)
- asenapine (Sycrest)
Just as the cause of bipolar disorder is not fully understood, there is no known cure for the illness, but it can be managed with medication, education, and psychotherapy, which is the classic three-pronged method for treating the disease. Bipolar disorder is a chronic illness with no cure—yet.