Psychiatric Drugs-Types

Lithium carbonate, one of several lithium compounds used as a mood stabilizer for manic depression or bipolar disorder. Lithium, in the salt family, is also a powerful mood altering drug. While a naturally occurring compound, when used as a mood stabilizer, it can have strong and multiple side effects.

Regular blood testing is necessary when taking lithium and the levels of the drug need to be closely monitored. It is used in treating bipolar disorder and some severe depressions, although it's effectiveness is said to be very variable in treating depressions.

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Uses of mood stabilizers: Mania and hypomania. (Hypomania-close to mania).
The first mood stabilizer to be used was lithium, and it is the only drug that was developed specifically for use in bipolar disorder. It was first approved for use in treating mood swings by the FDA in the 1970s.

Most the other drugs classified as mood stabilizers are medications that were first used to treat seizure disorders, such as epilepsy. They are known as "anticonvulsants," since they are designed to inhibit or reduce the frequency of seizures. Interestingly, they also help stabilize mood swings.

Some heart-related medications called calcium channel blockers are being studied for use in treating bipolar disorder as mood stabilizers.

Bipolar disorder treatment, commonly includes mood stabilizers. Antipsychotics and antidepressants are also sometimes used along with a mood stabilizer.

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Commonly Used Mood Stabilizers: Generic name: carbamazepine
Trade name Tegretol
Generic: valporate
Trade name: Depakote

Mood Stabilizers uses and side effects:
Bipolar disorder, especially manic episodes. Tegretol-neurotoxic side effects have been noted, including unsteady gait, tremor, ataxia, and increased restlessness.

Depakote: fewer side effects than lithium, but can be sedating. Depakote is used much more frequently than lithium today, however, it carries a 2-3x higher risk of suicidality than lithium.

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Lithium - Side Effects:
Lithium, a mainstay in the treatment of bipolar disorder, has been reported to induce adverse effects in 35%?93% of patients who take it, and these adverse events often lead to noncompliance.

The side effects most frequently reported were:

Polyuria-polydipsia syndrome, which affected 36 (60%) of 60 patients.

Tremor (54% men v. 26% women, p < 0.05)

Weight gain during the first year (47% women v. 18% men, p < 0.05)

Clinical hypothyroidism (37% women v. 9% men, p < 0.05)

Source: Journal of Psychiatry and Neuroscience. 2002.

Other "real life" side effects for lithium are reported from numerous sources as follows:

slow verbalization

feeling somewhat "detached"

feeling detached from my own voice

emotionally detached

not feeling yourself

tiredness

tremors

lithium [emotional] flatness

Side effects for lithium are usually more intense in the first months and gradually improve slightly, although, persons who have been on lithium for many years, still describe some of the emotional detachment and other side effects listed here.

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Notes on lithium side effects from Depression Forum:

"....i was wondering as it's a mood stabilizer, if it blunts higher levels of mood...?...i don't ever get excited or highly aroused etc."

"...my emotions were flat ALL the time. I hated that. It did stabilize me and I thank God for that but I wanted to feel a little too." L. (www.depressionforums.org)

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Additional side effects or complications with lithium use:

"Lithium has been associated with birth defects."
Stopping after finding out one is pregnant "may be too late to prevent a birth defect." (Mondimor, p.91).

"A noticeable dulling of mental functioning and coordination," is listed as a major side effect. (Ibid, p. 92).

"Patients often complain that their ability to memorize and learn is affected and that they have a difficult-to explain sense of mental sluggishness."(Ibid, p. 92).

From book: Bipolar - A Guide for Patients and Families by Francis Mondimore.

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Mood Stabilizers page references:

1. Lithium side-effects and predictors of hypothyroidism in patients with bipolar disorder: sex differences>. (March 27, 2002). Chantal Henry Journal of Psychiatry and Neuroscience. Service Universitaire de Psychiatrie, CH Charles Perrens and INSERM U-394, Neurobiologie Intgrative, Bordeaux, France. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=161639

2. Mondimore, Francis Mark, M.D., (2006). Bipolar - A Guide for Patients and Families 2nd Edition. Baltimore: The John Hopkins University Press.

3. Read, K., Purse, M. Speaking from Experience - Lithium. (June 18, 2006). About.com. http://bipolar.about.com/cs/experience/a/sfe_lithgensfx.htm