The Mood Stabilizers for Bipolar Disorder

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If you have bipolar disorder, medication will be a key part of your treatment regimen along with therapy, healthy lifestyle choices, and other coping strategies. Mood stabilizers are one of the most important medications for treating bipolar disorder, and they will likely be prescribed to you. These medications control the extreme highs and lows of bipolar disorder, primarily reducing the risk of mania and hypomania, but some mood stabilizers also have antidepressant effects.

Mood Stabilizers

Lithium was the first mood stabilizer used to treat bipolar disorder and it is still used today. Anticonvulsant medications, originally used to treat seizure disorders and eventually found to help stabilize moods, are used for this purpose as well. Other medications, such as calcium-channel blockers, benzodiazepines, and antipsychotics also have mood stabilizing effects and may be used to treat bipolar disorder.

Lithium: The First Mood Stabilizer

Lithium is an excellent treatment for both mania and hypomania and it also has antidepressant effects. Although it is the oldest mood stabilizer, it is still a staple in the medical arsenal for treating bipolar symptoms. Today, lithium remains the only medication that was approved first for bipolar disorder, rather than being developed for other conditions or symptoms and later found to work as a mood stabilizer.

If your doctor chooses to prescribe lithium, you will need to have regular blood tests to make sure your lithium blood levels are in a therapeutic range, as levels that are too high can be toxic. Lithium is processed by the kidneys, so you will also need your kidney levels checked while on this medication. In addition, being dehydrated can cause lithium blood levels to rise, so be sure to drink enough fluids while on lithium.


Anticonvulsants are shown to relieve the symptoms of mania. They also called anti-epileptic drugs, as they were developed to treat seizure disorders. A very commonly used anticonvulsant for bipolar disorder is called Depakote (valproic acid). People who cannot tolerate lithium, or who have rapid-cycling bipolar disorder, tend to do well with this medication.


Acute episodes of mania result in psychosis in as many as two-thirds of those with bipolar disorder. In these people, antipsychotics are used frequently. They are also often used to decrease symptoms of mania until mood stabilizers, such as lithium or valproate, can take full effect. In some people, these medications may be used long-term. Several atypical antipsychotics, the newer generation of antipsychotics, also have antidepressant properties.

Calcium Channel Blockers

There is evidence that certain calcium channel blockers, typically used to treat high blood pressure, irregular heartbeats and other heart problems, are effective as mood stabilizers. Because they have fewer side effects than lithium and anticonvulsants, they may be an option for people who can't tolerate those medications.

However, calcium channel blockers must be taken at higher doses and more frequently, up to 4-6 times daily, in order to be effective for bipolar disorder. They may also be less effective than the first line medications above.


Anti-anxiety drugs in a class called benzodiazepines are sometimes used to gain rapid control of manic symptoms as mood stabilizers more slowly take effect. The benzodiazepines are central nervous system (CNS) depressants and fast-acting sedatives. These medications are primarily used to induce sleep, relieve anxiety and muscle spasms, and prevent seizures. They may also be used to help restore a normal sleep schedule.

Medications Take Time to Become Effective

It's important to note that most of these medications, with the exception of fast-acting benzodiazepines, typically take more than one month to become fully effective. As you wait for your medications to kick in, therapy, exercise, a solid sleep schedule, a good social support network, and a healthy diet can all make a big difference in how you feel.

Rapid Cycling Bipolar Disorder

If you have rapid-cycling bipolar, which means you have at least four mood episodes a year, it may take even more trial and error to find the right medications to stabilize your symptoms. Try to be patient and give it time until you find the right combination.

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Article Sources

  • Marcelle Mostert, MD and Steven L. Dubovsky, MD. When bipolar treatment fails: What’s your next step? Current Psychiatry. Vol. 7, No. 1 / January 2008. 
  • National Institute of Mental Health