Mood stabilisers

Many people affected by some type of psychotic illness will have to cope with extreme mood swings - periods of mania (feeling 'high') and periods of depression. These symptoms are usually associated with bipolar disorder, (manic depression) but may also affect some people with schizophrenia and personality disorders.

Some people are given a diagnosis of 'schizoaffective disorder' because they have some symptoms of schizophrenia and bipolar disorder. All of these conditions are types of psychotic illness, which means that people affected may at times lose touch with reality. Whatever the diagnosis, it is important that you receive appropriate medication for your symptoms when necessary, as well as other forms of care and support.

There are a number of drugs used to stabilise mood, including lithium, carbamazepine and sodium valproate. These three drugs are generally considered safe, if taken as directed, and are not addictive.

It is not known exactly how mood stabilisers work but it is thought that they probably even out or stabilise the speed at which the brain passes messages within the nervous system, and that they may involve correcting imbalances of brain chemicals.

Some antipsychotic medications are now being used to treat mania.

Drugs used as mood stabilisers include:

  • Lithium

Lithium is widely used for the maintenance and treatment of mania. It reduces both the number and severity of relapses. Lithium is least effective for rapid-cycling manic depression. Lithium comes in two forms, lithium carbonate (Priadel) and lithium citrate (Camcolit). Each is equally effective but if you are taking one that works for you, it's best not to change.

In order for the lithium therapy to work you must have a certain level in your blood stream; if the lithium in your blood goes above this level it can become toxic. To make sure that the lithium is working properly and is not at a dangerous level you will have to have regular blood tests every 3 months. It is also important that you do not go on low salt diets as these can alter the salt balances in the body and could cause lithium poisoning (lithium is salt based) – talk to your doctor if you want advice about this.

  • Valproate

Semisodium valproate (Depakote) is used for the treatment of mania in UK as the effect it has on the brain is very calming as it slows down the sending of messages to a normal rate. Approximately 50% of people having a manic episode respond to valproate. The effects of valproate are often felt soon after taking it.

  • Carbamazepine

Carbamazepine is used mainly for people with in the treatment of mood disorders. In order to be effective, carbamazepine has to reach a given level in the blood. In order to monitor this and to investigate whether you are on the best dosage, you may have to have several blood tests while you adjust to the drug. It may take several months for the drug to achieve the maximum control over mood swings.

  • Lamotrigine

Lamotrigine is particularly effective for people with the depressive symptoms of manic depression. Lamotrigine should begin to work as soon as you start taking the tablets. It is a preventative medicine as so will probably need to be taken for a long time.

  • Atypical antipsychotics

The newer antipsychotics have been found to have mood stabiliser properties and are now licensed for the treatment of manic depression. The first drugs to be licensed of this class are olanzapine and quetiapine. For more information, see the Antipsychotics section or contact the advice service for a copy of our booklet ‘Only the Best’ a user-friendly guide to antipsychotic treatments.

The Precribing Obervatory for Mental Health

The Prescribing Observatory for Mental Health [www] was launched in October 2005 to help specialist mental health services improve prescribing practice. POMH-UK carries out audits of prescibing standards, and produces a newsletter on key issues for mental health prescribing. You might be interested in their email discussion forum, where people can share their questions and views on mental health prescribing.

National Advice Service Factsheets

The information in this section is taken from the NAS factsheet, which you can download in pdf format and print for individual use.

Mood stabilisers factsheet