Side Effects and Complications of Mood Stabilizers

Introduction

Mood stabilizers are medications that regulate and stabilize mood by affecting the levels of certain chemicals in the brain, such as serotonin, dopamine, and norepinephrine. Some common mood stabilizers include lithium, anticonvulsants (Valproic acid, Carbamazepine, and Lamotrigine) antipsychotics. These medications are typically prescribed by a psychiatrist or other mental health professional and may be combined with other treatments, such as therapy or lifestyle changes.

What Is a Mood Stabilizer?

A mood stabilizer is a medication prescribed to individuals with mood disorders such as bipolar disorder, anxiety, and depression. They also help regulate mood swings, preventing intense shifts between emotional states. Mood stabilizers regulate the levels of certain neurotransmitters in the brain, such as dopamine, norepinephrine, and serotonin. These neurotransmitters play a vital role in mood regulation.

The primary purpose of mood stabilizers is to prevent or minimize the frequency and severity of mood swings. Mood stabilizers can also alleviate anxiety symptoms, manic or depressive episodes, agitation, and restlessness.

What Are the Types of Mood Stabilizers?

Types of mood stabilizers are

• Lithium: Lithium is one of the oldest and most widely used mood stabilizers. It regulates specific neurotransmitters within the brain, which involves serotonin and norepinephrine. Lithium can effectively treat both manic and depressive episodes, but it requires careful monitoring to ensure that blood levels remain within a safe range.

• Anticonvulsants: Several anticonvulsant medications have been found to have mood-stabilizing properties, including Valproic acid, Carbamazepine, and Lamotrigine. These drugs work by modulating the activity of ion channels in the brain, particularly those that regulate the flow of sodium and calcium ions. Anticonvulsants may be particularly effective in treating the manic episodes associated with bipolar disorder.

• Antipsychotics: Antipsychotic medications such as Risperidone, Olanzapine, and Quetiapine may also be mood stabilizers. These drugs work by modulating the activity of dopamine and other neurotransmitters in the brain. Antipsychotics may be particularly effective in treating the psychotic symptoms that can occur during manic episodes.

What Are the Effects of Mood Stabilizers?

The effects of mood stabilizers include:

• Reduce manic or depressive symptoms such as hallucination, sleep disturbances, delusion, and agitation. These medications are used for several weeks for effective results. Antipsychotics are also used along with mood stabilizers.

• After effective management of symptoms, mood stabilizers are known to prevent future relapses and rehospitalization in cases of schizophrenia and bipolar disorders.

• Mood stabilizers also help manage mood swings.

What Are the Side Effects of Mood Stabilizers?

The side effects of mood stabilizers include:

1. Lithium: Lithium is a potent mood stabilizer with specific side effects like:

• Tremors (fine hand tremors or shakes in the hands, arms, or legs).

• Increased thirst and urination as it affects the way the kidneys process water and electrolytes.

• Weight gain, particularly in the first few months of treatment. This can concern individuals who are already overweight or at risk of obesity.

• Hypothyroidism (an underactive thyroid).

• Chronic kidney disease or kidney failure.

• Slurred speech.

• Muscle twitching.

• Concentration, memory, and attention difficulties.

2. Anticonvulsants:

• Fatigue, muscle ache, or weakness.

• Dry mouth.

• Constipation or diarrhea.

• Loss of appetite.

• Nausea.

• Skin rash.

• Headache.

• Dizziness.

• Reduces sexual interest.

• Temporary hair loss.

• Some chronic side effects include:

• Confusion.

• Fever.

• Jaundice.

• Abnormal bleeding or bruising.

• Swelling of lymph nodes.

• Vomiting.

• Double vision.

• Affect blood cells and liver function.

3. Anticonvulsants: Side effects vary from person to person and include:

• Abnormal body movements or tremors.

• Rapid or slow movement.

• Being rigid.

• Irregular movements that are not under control.

• Weight gain.

• Raised cholesterol levels.

• Hyperprolactinemia results in a milky nipple discharge, missed periods, sexual dysfunction, risk of osteoporosis, reduced testosterone production, sperm, or both.

• Sedation (feeling relaxed and sleepy).

• Sleep apnoea syndrome.

• Seizures.

• High blood pressure.

• Risk of stroke.

• Blood clots in veins.

• Less glucose tolerance.

• Heart or blood vessels can be affected.

• A neuroleptic malignant syndrome that includes- fever, increased sweating, rigidity, confusion, rapid heartbeat, increased white blood cell (WBC) count, and increased levels of creatinine kinase. This is a rare but fatal side effect of antipsychotics.

• Pneumonia.

• Liver function disturbance.

• Skin disorders.

• Double vision.

• Restless legs syndrome (urge to move legs).

• Increase in drug or alcohol use.

• Photosensitivity.

• Neutropenia (reduced neutrophil count).

What Are the Complications Associated With Mood Stabilizers?

Complications associated with mood stabilizers:

• Weight Gain: Many mood stabilizers, including lithium and some anticonvulsants, can cause weight gain. This can lead to several health problems, including obesity, diabetes, and heart disease.

• Gastrointestinal Problems: Some mood stabilizers can cause gastrointestinal side effects, such as nausea, vomiting, and diarrhea. These side effects can be unpleasant and may make taking the medication as prescribed difficult.

• Kidney Problems: Lithium, one of the most commonly used mood stabilizers, can be toxic to the kidneys if not adequately monitored. People taking lithium need regular blood tests to check their kidney function.

• Thyroid Problems: Lithium can also affect the thyroid gland, leading to hypothyroidism (an underactive thyroid). Hypothyroidism can cause symptoms such as fatigue, weight gain, and depression.

• Cognitive Impairment: Some people taking mood stabilizers may experience cognitive side effects, such as difficulty with memory, concentration, and attention.

• Teratogenicity: Mood stabilizers are known to be teratogenic, which means they can harm a developing fetus if taken during pregnancy. Women of childbearing age who are taking mood stabilizers need to use effective birth control and talk to their physician regarding the risks associated with medications during pregnancy.

• Liver Problems: Some mood stabilizers, such as carbamazepine and valproic acid, can cause liver problems in rare cases. People taking these medications need regular blood tests to monitor their liver function.

Can a Person Discontinue Mood Stabilizers?

A person should talk to their doctor before discontinuing these medications as they can cause withdrawal symptoms. Usually, it is advised not to stop them as they can lead to severe symptoms if stopped suddenly. The symptoms are based on the dosage and medications taken.

If a person wants to discontinue the medicine then the doctor will give a plan by slowly reducing the dosage over a few days by observing the signs and symptoms.

Conclusion

While mood stabilizers can effectively manage bipolar disorder, they can also have potential side effects and complications. These can range from weight gain and gastrointestinal problems to kidney and thyroid problems, cognitive impairment, teratogenicity, and liver problems. Individuals prescribed mood stabilizers should be aware of the complications and work closely with their doctor to observe their symptoms and adjust their regimen accordingly. By assessing the advantages and disadvantages of mood stabilizers, individuals with bipolar disorder should try to manage their symptoms and enhance their overall well-being.