Mood stabilizers: what they do and what to expect

Mood stabilizers are medicines used to even out big mood swings — most often for bipolar disorder. They don’t work like antidepressants or antianxiety pills. Instead, they help prevent mania and depression from coming back, reduce mood swings, and can lower the risk of self-harm in people with bipolar illness.

Common mood stabilizers

Here are the main types you’ll hear about and what makes each one different:

Lithium — A long-standing choice. It’s especially good at preventing mania and can reduce suicide risk. You’ll need regular blood tests (levels, kidney and thyroid checks). Common side effects include thirst, mild tremor, and stomach upset. Watch for signs of toxicity: extreme nausea, confusion, or severe tremor mean call your doctor right away.

Valproate (valproic acid) — Often used for rapid cycling or mixed moods. It can cause weight gain and hair thinning, and it’s dangerous in pregnancy (birth defects). Doctors check liver function and blood counts sometimes.

Lamotrigine — Better at preventing bipolar depression than mania. It’s usually well tolerated but must be started slowly because of a rare skin reaction (Stevens-Johnson syndrome). If you get a rash, stop and call your clinician immediately.

Carbamazepine — Sometimes used when others don’t work. It interacts with many drugs because it speeds up liver enzymes. Blood tests and monitoring are common.

Practical tips for taking mood stabilizers

What should you expect day-to-day? First, follow the dosing plan and don’t stop suddenly — abrupt stopping can trigger relapse. Keep regular follow-up appointments for blood tests; levels matter. With lithium, try to keep salt and water intake steady: big changes in sodium or dehydration can raise lithium levels.

Tell your doctor about all medications and supplements. NSAIDs, ACE inhibitors, and some diuretics can raise lithium levels. Hormonal birth control can affect some anticonvulsants. If you’re planning a pregnancy or could become pregnant, talk to your clinician before changing meds — some options are safer than others in pregnancy.

Watch for side effects and write them down. Fatigue, weight change, tremor, or GI upset are common but often manageable. Serious warning signs include new confusion, severe dizziness, fast heartbeat, or a spreading rash — these need urgent care.

Medication is only part of the plan. Good sleep, a steady routine, stress management, and avoiding alcohol help mood stability a lot. If mood swings worsen or you get suicidal thoughts, contact your provider or emergency services right away.

Want help choosing or managing a mood stabilizer? Talk with a psychiatrist or pharmacist who knows your history. They can match the right medicine to your symptoms and keep you safe while you get better.