Mood stabilizer drugs are medications that are primarily used to treat bipolar disorder, a mental health condition characterized by cycles of mania and depression. These drugs can help stabilize mood and prevent extreme shifts in mood, energy, and activity levels.
- These drugs are also known as anti-manic drugs & ionic drugs.
Mechanism of action
- One theory suggests that mood stabilizers work by modulating the activity of neurotransmitters in the brain, such as serotonin, dopamine, and norepinephrine. For example, lithium, a commonly used mood stabiliser, is thought to increase the availability of serotonin and decrease the release of norepinephrine and dopamine.
- Another theory proposes that mood stabilizers work by regulating intracellular signaling pathways, such as the cyclic adenosine monophosphate (cAMP) and protein kinase C (PKC) pathways. For example, lithium has been shown to inhibit the enzyme inositol monophosphatase, which reduces the availability of inositol, a molecule involved in the cAMP pathway.
Indication
Mood disorders like mania, bipolar disorder, cyclic depression, psychosomatic disorders.
Main mood stabiliser drugs :
Lithium carbonate
Lithium curate
Other anti-manic drugs :
Carbamazepine, Olanzapine, Ziprasidone,Risperidone (all are atypical antipsychotic drugs)
Lithium carbonate
Lithium carbonate is a medication used primarily to treat bipolar disorder (manic-depressive illness), a mental health condition characterized by extreme mood swings.
- It was the first drug used for the treatment of mood disorder by Cade in 1949.
- Blood serum therapeutic range of lithium carbonate is 0.6 to 1.2 mEq/liter and toxic level is above 1.5 to 2 mEq/liter.
- Level of lithium should be checked at 1-2 month interval because there are fewer margins between therapeutic range and toxic range.
- Blood sample to Check serum therapeutic level should be taken in the morning; 12 to 14 hours after the last dose was taken.
- Advice the patient to increase fluids and salt intake.
- Hyponatremia can precipitate lithium toxicity (lower the excretion rate of lithium), so it should not be administered to patients following a salt-free diet.
- There is no specific antidote for lithium carbonate.
- Osmotic diuretic and sodium bi-carbonate (NaHCO3) are used to increase excretion of lithium carbonate.
- Assess renal function test (it excretes through kidney, so can damage it) in toxicity, e.g. BUN, Creatinine, etc.
- Also monitor thyroid function because it can depress thyroid gland (causes hypothyroidism).
- Avoid into pregnancy because it crosses placenta barrier.
Sign and symptoms in lithium toxicity.
Nausea, vomiting, polyuria, polydipsia, severe diarrhea, ataxia, slurred speech, tinnitus, blurred vision, irregular tremors, nystagmus, deep tendon hyper-reflexia, hallucination, abnormal thyroid function, T-wave depression and Ebstein’s anomaly during pregnancy.
Common side effects of lithium carbonate Include hand tremors, increased thirst and urination, weight gain, and mild cognitive impairment. More serious side effects such as kidney damage and thyroid problems can also occur with long-term use of this medication.
Other mood stabiliser
Carbamazepine, gabapentine, lamotrigene, divalproex, topiramate, valporic sodium (valporate).