Mood stabilizers (mood stabilizers) are a group of psychotropic drugs used in the treatment of bipolar disorder and borderline disorders. Normotymics reduce psychomotor hyperactivity and stabilize the mood, preventing the occurrence of alternating episodes of depression and mania. When are mood stabilizers recommended and how do they work?

Mood stabilizers , otherwisemood stabilizers(mood stabilizers) belong to the group of anticonvulsants. They were initially used to prevent seizures, but since the 1970s they have also been used to treat mood disorders in bipolar disorder (bipolar disorder). Sometimes mood stabilizers are used in the treatment of borderline personality disorders, less often as a support in the pharmacological treatment of recurrent depression (mainly lithium).

Mood stabilizers (mood stabilizers) - classification and types

Normothymic drugs are divided into two categories:

  • first-generation (classic) drugs - they appeared on the market as the first pharmaceuticals for the treatment of bipolar disorder, these are: lithium, valproic acid and its derivatives, and carbamazepine;
  • second-generation drugs (new) - safer mood stabilizers with a lower risk of side effects: lamotrigine and atypical antipsychotics (quetiapine, olanzapine, aripiprazole, risperidone, ziprasidone, clozapine).

Lit

The first drug from the group of mood stabilizers intended for the treatment of bipolar disorder was lithium (trade names: Eskalith, Lithobid). Its mechanism of action is not entirely clear. It is believed that lithium regulates the concentration of sodium-potassium adenosine triphosphatase in nerve cells - disturbances in the activity of this enzyme are the likely cause of bipolar disorder.

In medicine, lithium is used in the form of carbonate, which is very effective, but on the other hand can cause many side effects. In order for lithium to permanently prevent disease symptoms, it must be taken permanently, and this in turn is associated with an increase in the amount of this element in the body. There is a very fine line between the therapeutic and toxic dose of lithium, so over timeblood levels of the drug should be monitored regularly (at least once a month) during treatment. It should not exceed 1.0 mmol / l. When it reaches a value above 1.2 mmol / l, lithium becomes toxic. It is especially easy to poison in the states of dehydration and sodium deficiency in the body.

Despite the risk of toxicity, lithium completely eliminates relapses in 40-50% of patients with bipolar disorder. Its effect is best documented and, if the preparation is used under strict medical supervision, the substance should not present a risk.

Valproic acid

Valproic acid (Depakote, Convulex) inhibits the central nervous system, regulates the transport of sodium and calcium ions through cell membranes and protects nerve cells, preventing their damage. This substance is generally much better tolerated by patients than lithium carbonate, and at the same time is very effective. For this reason, valproic acid and its derivatives are currently the most commonly used drugs in the treatment of bipolar disorder. They can also be safely combined with other psychotropic drugs, e.g. antidepressants.

Carbamazepine

Carbamazepine (Amizepin, Finlepsin, Neurotop, Tegretol, Timonil) eliminates anxiety and depressive states, reduces irritability, aggressiveness, prevents hyperactivity and pain attacks, therefore, in addition to bipolar disorder treatment, it has been used in the treatment of various forms of neuralgia. It is generally prescribed to people who have failed or cannot take lithium. Carbamazepine easily interacts with other psychotropic drugs and can cause side effects (headache, dizziness, nausea, tremors, restlessness, sedation, allergies).

Lamotrigine

Lamotrigine (Lamitril) has a mild antidepressant effect and is especially effective in patients with bipolar disorder who have been diagnosed with rapid cycling from depressive to manic and vice versa. Compared to older generation drugs, it has few side effects. Lamotrigine is also prescribed when other mood stabilizers and borderline therapy have failed.

Antipsychotics

The main indication for the use of antipsychotic drugs is schizophrenia, but they are also effective in alleviating manic episodes in the course of bipolar disorder. In addition, they support the therapy with mood stabilizers, which is why patients with bipolar disorder are often recommended to take mood-stabilizing drugs and antipsychotics at the same time.

Mood stabilizers (mood stabilizers) - indications fortreatment

The basic indication for treatment with mood stabilizers is bipolar disorder. In patients with this ailment, mood stabilizers, as the name suggests, stabilize well-being, preventing both depressive and manic states. The patient no longer experiences mood swings, does not succumb to deep sadness and melancholy, and does not show excessive excitability and euphoria. In the case of bipolar disorder, psychiatrists usually recommend the use of lithium (or another new-generation drug) with an antipsychotic drug.

Mood stabilizers, contrary to what the name might suggest, are not a universal medicine for improving your mood. These are chemicals that greatly affect the neurotransmission in the brain. Their use may only be ordered by a psychiatrist.

Mood stabilizers are sometimes also prescribed to people with borderline disorders, especially when sudden mood swings prevent them from functioning normally. In this case, however, pharmacotherapy is only a temporary method of alleviating the effects of the disease, because only psychological therapy can bring lasting improvement.

Mood stabilizers are sometimes used to treat unipolar (recurrent) depression, but only in combination with antidepressants. Then the stabilizers are designed to increase the effectiveness of therapy with antidepressants. It is worth noting that the use of only mood stabilizers in depressed patients, without the simultaneous treatment with antidepressants, may not only bring no results, but also aggravate the symptoms of the disease.

Important

Mood stabilizers are psychotropic drugs that can only be prescribed by a psychiatrist after examining the patient and making a proper diagnosis. They should not be taken without consulting a specialist, because in people who have not been diagnosed with bipolar disorder and borderline disorder, mood-stimulants do not give any therapeutic effects, but they can cause serious side effects.

Mood stabilizers (mood stabilizers) - side effects

The most serious risk of side effects is with lithium treatment. If the therapeutic dose is exceeded, poisoning may occur, such as: convulsions, confusion, abnormal heart rhythms and even coma. Drugs with this element can also cause:

  • muscle tremors,

If lithium is withdrawn too abruptly, the risk of attempting suicide increases, so do not give up lithium treatment on your own!

  • excessive reduction of the drivepsychomotor,
  • kidney damage,
  • excessive thirst,
  • polyuria,
  • nausea, vomiting, diarrhea,
  • memory impairment,
  • weight gain.

Relatively many side effects can occur with carbamazepine treatment. These include:

  • visual disturbance
  • nausea,
  • dizziness and headaches,
  • trembling and anxiety,
  • skin lesions,
  • sedation,
  • liver damage,
  • pancreatitis.

Other mood stabilizers generally cause less severe side effects that disappear on their own after a few days. The most common are gastrointestinal disorders, headaches, drowsiness, hair loss.

This will be useful to you

This should be remembered when taking a treatment with normothymic drugs:

  • mood stabilizers are not addictive;
  • the first effects of treatment with mood stabilizers may appear even several weeks after taking the first dose of the drug;
  • normotymiki is used for a long time for a period of several years, and when there is a tendency to relapse, even throughout life; taking medication on an ad hoc basis has no effect;
  • mood stabilizers may impair the ability to drive vehicles and operate machinery;
  • sometimes the use of stabilizers may be associated with a decrease in sexual desire and erectile dysfunction in men;
  • Some mood-stabilizing drugs show teratogenic effects (toxic to the embryo or fetus), therefore you should use effective contraceptive methods during their use.

Category:

Psychiatry