Mood stabilizers

A mood stabilizer is a psychiatric pharmaceutical drug used to treat mood disorders characterized by intense and sustained mood shifts, typically bipolar disorder type I or type II or schizophrenia.

Used to treat bipolar disorder, mood stabilizers suppress swings between mania and depression. Mood-stabilizing drugs are also used in borderline personality disorder and schizoaffective disorder.

The term "mood stabilizer" does not describe a mechanism, but rather an effect. More precise terminology is used to classify these agents.

Drugs commonly classed as mood stabilizers include:

Many agents described as "mood stabilizers" are also categorized as anticonvulsants. The term "anticonvulsant mood stabilizers" is sometimes used to describe these as a class. Although this group is also defined by effect rather than mechanism, there is at least a preliminary understanding of the mechanism of most of the anticonvulsants used in the treatment of mood disorders.

There is insufficient evidence to support the use of various other anticonvulsants, such as gabapentin and topiramate, as mood stabilizers.

In routine practice, monotherapy is often not sufficiently effective for acute and/or maintenance therapy and thus most patients are given combination therapies. Combination therapy (atypical antipsychotic with lithium or valproate) shows better efficacy over monotherapy in the manic phase in terms of efficacy and prevention of relapse. However, side effects are more frequent and discontinuation rates due to adverse events are higher with combination therapy than with monotherapy.

Most mood stabilizers are primarily antimanic agents, meaning that they are effective at treating mania and mood cycling and shifting, but are not effective at treating acute depression. The principal exceptions to that rule, because they treat both manic and depressive symptoms, are lamotrigine, lithium carbonate and quetiapine.

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