Mood stabilizers side effects

Doses can be started at 400 mg to 600 mg/day in divided doses, and increased by 200 mg/day every 2 to 4 days up to 10 to 15 mg/kg/day. Outpatients should be titrated upward more slowly to avoid side effects. Many patients are able to tolerate once daily dosing once their mood episode has stabilized. 

Oxcarbazepine has mood-stabilizing effects similar to those of carbamaz-epine, but with milder side effects, no autoinduction of metabolizing enzymes, and potentially fewer drug interactions. There are fewer data supporting its efficacy than there are for carbamazepine s efficacy. 

Increasing the dose of the current mood stabilizer deserves consideration when the medication level is at the lower end of the therapeutic range. This has the advantage of keeping the treatment simpler and less costly. However, as the dose is increased, the potential for intolerable side effects or toxicity (especially with lithium) becomes greater. 

In CONCLUSION, lithium is universally accepted as a mood-stabilizing drug and an effective antimanic agent whose value is limited by its poor therapeutic index (i.e. its therapeutic to toxicity ratio). Neuroleptics are effective in attenuating the symptoms of acute mania but they too have serious adverse side effects. High potency typical neuroleptics appear to increase the likelihood of tardive dyskinesia. Of the less well-established treatments, carbamazepine would appear to have a role, particularly in the more advanced stages of the illness when lithium is less effective. 

It is very important to choose medications with the least possibility of making an ill pediatric patient suffer additional morbidity from side effects to medication directed at mood or behavior. For these reasons, mood stabilizers such as lamotrigine (which carries with it the risk of a severely toxic rash) should be seen only as third- or fourth-line agents. 

Janicak PG, Munson LG. Practical management of adverse effects associated with mood stabilizers. In Balon R, ed. Adverse effects of mood stabilizers practical management of the side effects of psychotropic drugs. New York Marcel Dekker, 1999 119-143. 

In a 6-week open study of risperidone (mean dosage 4.7 mg/day) in combination with mood-stabilizing treatments (usually lithium, carbamazepine, or valproate) for the treatment of schizoaffective disorder in 102 patients, 95 of whom completed the trial, at week 4 most patients had improved symptom severity and 9.3% were completely symptom-free (35). There were no statistically significant differences between baseline and week 4 in the severity of extrapyramidal symptoms, as measured by the UKU Side-Effect Rating Scale subscale for neurological adverse effects other adverse effects included depressive symptoms (n = 13), exacerbation of mania ( n = 5), drowsiness (n = 3), and impotence (n = 2). 

Switch to another mood stabilizer with fewer side effects or to extended release carbamazepine... 

I was surprised when Gordon told me he had experienced a few side effects from his alkaline diet, but then he revealed with a grin what they were his weight had stabilized, he was sleeping better than ever, he had lots more energy, and his mood swings were a thing of the past. 

Many considerations need to be explored before taking MAOIs. Accidental or intentional overdose is fairly common in depressed patients using MAOIs, so the patients must be somewhat stabilized in terms of mood and must also be reliable. However, with the introduction of RIMAs, the risk has been considerably lowered, as well as the side effects. In any case MAOIs provide the only relief for some refractory individuals— especially those with severe depression—and thus are invaluable to clinicians and their patients. 

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