Mood stabilizers are the medication of choice for bipolar disorder: they treat the highs (mania) and lows (depression) of the disorder. The medication is also used during the maintenance phase, where the patient has a normal mood; mood stabilizers help prevent mood cycling from occurring. Mood stabilizers are also used for other conditions "off-label," where the drug is not approved by the Food and Drug Administration (FDA) for the treatment of that disorder.
Mania
Mania is one part of the bipolar disorder, where the patient has an inflated self-esteem, elevated mood, unusual talkativeness and racing thoughts. Helpguide.org states that lithium was the first manufactured mood stabilizer and helps control mania symptoms. Other mood stabilizers are anticonvulsants, meaning they were originally used to treat epilepsy. Valproic acid, one of the anticonvulsant mood stabilizers, is prescribed if the patient cannot tolerate lithium, or has mania with psychotic symptoms, mixed mania (mania and depression symptoms at the same time) or rapid cycling. Other mood stabilizer options for mania include topiramate, carbomazepine and lamotrigine.
Bipolar Depression
The second part of bipolar disorder, bipolar depression is characterized by sadness, sleeping problems, trouble concentrating and suicidal thoughts. It is not treated the same as major depression, since antidepressants can cause rapid cycling with bipolar disorder. If an antidepressant is combined with lithium, however, it is safe for a bipolar depression patient to take. Helpguide.org states that certain mood stabilizers can treat bipolar depression without the side effect of triggering mania. These mood stabilizers include lamotrigine, olanzapine and quetiapine.
Off-Label Conditions
When a medication is prescribed off-label, the psychiatrist must consider if the medication has benefits for that particular disorder and if evidence is available; if no evidence of therapeutic benefits is available, clinical monitoring may be done. In the article "A survey of the off-label use of mood stabilizers in a large psychiatric hospital," the authors Camilla Haw and Jean Stubbs monitored off-label prescription of mood stabilizers to mood disorders other than bipolar disorder. Of the patients in the hospital receiving a mood stabilizer, 94.7 percent were getting them off-label. Patients with disorders like post-traumatic stress disorder, schizophrenia and aggression received mood stabilizers off-label.
