According to the American Psychiatric Association's "DSM-IV-TR," mood disorders are classified into two categories, disorders with only depression and those with depression and mania, or intensely highs mood, known as bipolar disorder. Mood stabilizing medications aim to moderate the highs and lows. Often, mood stabilizers are combined with anti-depressants, depending on the individual. Sometimes, anti-depressants can cause a manic episode, so success with this combination varies.
Lithium
The first medication recognized as effective in stabilizing mood was Lithium. This chemical actually occurs naturally in our bodies. Lithium has positive effects on the nervous system, but how it actually works in unknown, according to MayoClinic.com. According to the text, "Abnormal Psychology," lithium can be toxic, causing symptoms such as tremors, vertigo, confusion, cardiac dysrhythmias, or abnormal heart rhythm, and death. Careful monthly monitoring of blood lithium levels is required when taking this drug. Lithium is most effective in treating mania and most patients have some benefit from its use.
Antidepressants
This is a broad category of drugs. Antidepressants are not technically classified as mood stabilizers but work to reduce symptoms of depression. They are commonly used in combination with mood stabilizers, and depression is classified as a mood disorder. "Abnormal Psychology" lists three types of antidepressants: Monoamine oxidase inhibitors, or MAOs; tricyclics; and selective serotonin reuptake inhibitors, or SSRIs. All work similarly with 50-70 percent success rate. According to FamilyDoctor.org, when depression occurs, chemicals in the brain needed for normal functioning, known as neurotransmitters, are unavailable due to ineffective uptake of the chemical, or not enough of the chemical. Anti-depressants work to increase this availability. Some common antidepressants include fluoxetine, citalopram, bupropion and amitriptyline.
Anticonvulsants
Originally designed to treat seizure disorders such as epilepsy, anticonvulsants, says Helpguide.org, have shown effective for reducing mood swings. These drugs are typically used when lithium does not work, however they can cause mild to serious side effects such as rashes, blood disorders, liver trouble and an increased tendency for suicidal thoughts. These drugs work similarly to lithium in reducing mania. Psycholgoy Information Online lists this class of drug as especially helpful for people who go through cycles of depression and mania very quickly, sometimes in a matter of hours or days. Common anticonvulsants include Depakote, Lamictal, Saphris, and Depakene.
Antipsychotics
When lithium and anticonvulsants prove ineffective, antipsychotics are another option. These drugs work similarly to reduce mania according to "Abnormal Psychology." Traditionally, they are used to treat psychiatric disease with psychotic episodes such as hallucinations, delusions, disorganized speech or thought, and disordered thinking. Antipsychotics may also be combined with other mood stabilizers and antidepressants. Helpguide.com lists common antipsychotics that include Olanzapine, Risperidone and Abilify. Side effects can include sexual dysfunction, constipation, weight gain, drowsiness and blurred vision. Problems with attention span and memory and uncontrollable body movements can also occur while using these drugs.
Considerations
One common problem with the effectiveness of mood stabilizers and antidepressants is that people often stop taking their medication, either because they are feeling better and think they don't need them, or because they actually desire the manic phases of bipolar disorder that are often feelings of elation, says Abnormal Psychology. Not all medications will affect people the same, so treatment will vary and often consists of repeated trial and error over several months or more. The body adjusts to the medications and sometimes drugs that were previously effective may no longer provide the same benefit. Medication changes should only come from a physician and precaution should always be taken with any medication while nursing or pregnant.
References
- HelpGuide.org: The Bipolar Medication Guide; Melinda Smith, M.A. And Jeanne Seagal, Ph.D.; 2009
- MayoClinic.com: Bipolar Disorder
- Psychology Information Online: Medication for Bipolar Disorder
- Abnormal Psychology, Eleventh Edition; Ann M. Kring, Sheri L. Johnson, Gerald C. Davison and John M. Neale; 2010
- FamilyDoctor.org: Antidepressants: Medicine for Depression
