MOOD STABILIZERS FOR BIPOLAR DISORDER (MANIC DEPRESSION)
Updated 09/10

 

Group Main Use	Medication Brand/Generic	Form	Dose Schedule	Dose Range	Most Common Side Effects for Group	Pros for Group	Cautions for Group
Mood stabilizers (Bipolar, booster)	Eskalith CR 450 Lithobid Lithonate Lithotab Lithium Carbonate Li2 Co3	Capsules Tablets 300mg 450mg	2 to 4 times a day	Blood level 0.6-1.2	Lithium: nausea, GI irritation, diarrhea, vomiting, lower thyroid function, may increase white blood cells, tremor, skin rashes. If dose too high side effects increase, may increase appetite.	Mood stabilizers are first choice for Bipolar Disorder (manic-depression). They are also used to boost the effects of antidepressants or help impulse control, violence. Lithium is the best studied and may also treat unipolar depression. Slow release versions more convenient. Tegretol, Topamax, Neurontin, Lamictal, Zonegran, and Depakote are also used for seizures. Depakote may best help rapid cycling and mixed mania/depression. It also helps prevent migraines. Tegretol XR, Carbatrol, and Equetro are all extended release form of carbamazepine. Trileptal can be seen as a refined Tegretol without the many interactions or blood count risks. Thus, no regular blood tests.	Lithium has more nuisance side effects but not serious usually except overdosage. Depakote may rarely seriously harm the liver or pancreas or decrease platelets (clotting) and Tegretol may rarely seriously lower blood counts. Thus depending on which med labs are usually important to check such as blood level of medicine, thyroid, liver, blood count. Depakote and Lithium may increase weight somewhat. Interactions may be significant and varied with Tegretol. All should be avoided if pregnancy, if possible. Mood stabilizers offer little help for most anxiety unless as booster or part of Bipolar. Hyponatremia (low sodium) risk is increased with Trileptal.
	Depakote valproic acid Depakote ER valproate divalproex	Tablets 125mg 250mg 500mg ER=Extended Release 250 mg 500mg Sprinkles (capsules) 125mg	2 to 3 times a day	Blood level 50-125	Depakote: sedation (usually mild), may increase appetite, occassionally associated with mild to moderate hair loss. GI irritation. May increase energy.
	Tegretol carbamazepine Carbatrol Equetro Trileptal oxcarbazepine	Tablets 100mg (chewable) 200mg XR (extended release) 100mg, 200mg, 400mg suspension 100mg/5ml Capsules 200mg, 300mg Capsules 100, 200, 300mg Scored tablets 150mg, 300mg, 600mg suspension 300mg/5ml	2 to 3 times a day XR one or 2 times a day twice a day twice a day twice a day	Blood level 4-12   600-2400mg/day no blood level	Tegretol: sedation, dizziness, nausea, double vision, unsteady gait if level high, usually mild insignificant drop in blood counts. Similar to Tegretol without blood count risks and less interactions.