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Mood-Stabilizers for Bipolar Disorder

Mood stabilizers balance certain brain chemicals (neurotransmitters) that control emotional status and behavior. When these brain chemicals are in proper balance, the symptoms of depression are reduced. Using mood stabilizer medications is helpful in 50% of all bipolar subtypes.

Mood stabilizers can be prescribed with other medications (such as antidepressants) used to treat people who have episodes of depression or mania.

Lithium Carbonate (Eskalith, Lithane, and Lithobid)

Lithium Carbonate (Eskalith, Lithane, and Lithobid) is effective in balancing a person's mood. It can be taken for a longer period of time or used as maintenance therapy. How it works is not completely understood though it may affect certain brain chemicals (neurotransmitters) that cause a person to have mood changes.

Lithium is a salt and acts like other salts (such as sodium) in a person's body. Any change in the balance between body salts and liquids (mostly water) in a person's body can change the amount of lithium carbonate in the blood. It is important that Lithium carbonate blood levels be kept within a certain range.

Levels that are high can cause serious side effects, even death. Levels that are low can cause symptoms of mania and/or depression. People who take lithium carbonate need to learn how to keep their lithium carbonate blood levels at a safe and effective level. They also need to know the signs of high lithium carbonate in their blood.

Lithium is often taken with other medications (such as antipsychotics or anticonvulsants) for more effective treatment of bipolar disorder.

Side effects of Lithium Carbonate can include:

  • Nausea, loss of appetite, feeling of fullness or swollen stomach, and/or stomach upset
  • Dry mouth, increased thirst, and increased urination
  • Headache, slight memory loss, or confusion
  • Sensitivity to cold
  • Tiredness and sleepiness
  • Weight gain in the first few months of use
  • Slight hand tremor or trembling
  • A taste of metal in the mouth
  • More serious side effects can include blacking out, slurred speech, changes in heart rhythm or a heart block, and an increase in the number of white blood cells (not usually due to an infection)

People who take lithium carbonate also need to be aware of the following:

  • Because lithium carbonate may make you tired and less alert, avoid driving a car or using other dangerous machinery until you know how lithium affects you.
  • Always seek care from a health professional if you are a woman and become pregnant while taking lithium carbonate. Women who breast-feed their babies also need medical care from a health professional.
  • Do not drink alcohol if you are taking lithium carbonate. Lithium can hide the signs of alcohol intoxication, and you can get life-threatening amounts of alcohol in your blood.
  • Always seek medical treatment if you notice signs of too much lithium in the blood.
  • Always tell each health professional who treats you that you are taking lithium carbonate. Taking certain medications can interfere with the amount of lithium in your blood. Some medications can cause your lithium blood level to get too high and other medications can cause it to get too low.
  • Taking antidepressant medications may trigger an episode of mania. Taking antidepressants with other medications (such as lithium) may help reduce the likelihood of this happening.
  • Do not stop taking these medications suddenly. You should taper off of these drugs slowly to avoid negative and serious side effects.
  • High blood levels of lithium carbonate can be life-threatening. People who take lithium carbonate need to have their blood checked about every two weeks to measure the amount in their blood.
  • Your doctor will need to test the function of your liver periodically while you are taking these medications.

Carbamazepine (Tegretol, Epitol)

Carbamazepine (Tegretol, Epitol) should not be taken for long periods of time or used as a maintenance medication. It causes fewer side effects than lithium carbonate.

Side effects of Carbamazepine can include:

  • Dry mouth and throat
  • Constipation
  • Problems urinating
  • Dizziness or drowsiness
  • Loss of appetite, nausea, and vomiting