Mood stabilizer is the general term for medications that reduce the frequency and intensity of mood episodes in bipolar disorder, both the highs of mania or hypomania and the lows of depression. The classic agent is lithium, a naturally occurring salt used in psychiatry since the 1950s. Lithium remains the best-studied treatment for preventing relapse and is the only mood stabilizer with strong evidence for reducing suicide risk. It requires regular blood tests to keep levels in a narrow therapeutic range and to monitor kidney and thyroid function.
Several anticonvulsants are also used as mood stabilizers. Valproate (Depakote) is effective for acute mania and mixed states. Lamotrigine (Lamictal) is especially useful for preventing bipolar depression and has fewer metabolic effects, though it must be started slowly to avoid a rare but serious rash. Carbamazepine (Tegretol) is an older option used when others fail. Many atypical antipsychotics, such as quetiapine, lurasidone and aripiprazole, also function as mood stabilizers and are often combined with lithium or lamotrigine. Mood stabilizers matter in depression care too: antidepressants alone can trigger mania in people with unrecognized bipolar disorder, so your provider screens for a history of elevated mood before prescribing one. Stedfast Psychiatry provides the laboratory monitoring these medications require and coordinates with your primary care physician on kidney, thyroid and metabolic results.