Mood stabilizers may be used to reduce anger,
anxiety, depression, impulsivity (acting without thinking), or attempts at self-harm associated with
borderline personality disorder.1 A few medicines
commonly used as mood stabilizers are:
Mood stabilizers are taken by mouth as pills or
These medicines help stabilize certain brain chemicals
neurotransmitters, which control emotional temperament
and behavior. Balancing these brain chemicals may reduce symptoms of borderline
Carbamazepine is an antiseizure
medicine that is used as a mood stabilizer.
It causes different side effects
than lithium. It can interact with other medicines, and you need to be watched
carefully when you are taking this medicine. Side effects of carbamazepine can include
a dry mouth and throat, constipation, unsteadiness, drowsiness, loss of
appetite, nausea, and vomiting.
People who take carbamazepine
need to have regular tests to measure the amount of carbamazepine in their
blood. They also need to have tests to check liver function and blood cell count.
Carbamazepine should not be used along with monoamine oxidase inhibitors
(MAOIs), because serious—sometimes fatal—reactions can occur.
Carbamazepine can interact with birth control pills (oral
contraceptives), making them ineffective in preventing pregnancy.
Avoid drinking alcohol while taking carbamazepine. It can increase some of the side effects of carbamazepine. And drinking alcohol with this medicine can increase your risk for seizures.
Grapefruit and grapefruit juice may interact with carbamazepine. This may have dangerous effects. Talk with your doctor about the use of grapefruit products.
Divalproex is an antiseizure medicine
that is used as a mood stabilizer.
It can cause side effects such as drowsiness, nausea,
trouble sleeping, dizziness, or weight gain. Other side effects
that are more serious can occur but are rare. They include liver problems, pancreatitis, and a severe
People who take divalproex need to have
regular tests to measure the amount of divalproex in their blood. They also need to have
tests to check liver function and blood cell count.
Lithium can be taken for a longer period of
time or used as maintenance therapy.
Side effects of lithium may include
nausea, vomiting, diarrhea, trembling, and an increased thirst and need to
urinate. Weight gain in the first few months of use is common, along with
drowsiness and a metallic taste in the mouth.
effects of lithium that are more serious can include blacking out, slurred speech, thyroid
dysfunction, kidney dysfunction, changes in heart rhythm or other heart
problems, and an increase in the number of white blood cells (not usually
caused by an infection).
People who take lithium need to have
regular tests to measure the amount of lithium in their blood. They also need to have
tests to check thyroid function, kidney function, and blood cell count.
High blood levels of lithium can be life-threatening. Sometimes other
prescription and nonprescription medicines cause higher- or lower-than-expected
amounts of lithium in the blood. If you and your doctor decide you should take
lithium, it is important to tell your doctor about all of the other medicines
you are taking.
Do not stop taking these medicines suddenly. You should taper off of these drugs slowly with the help of
your doctor, to avoid negative and serious side effects. While you are taking
carbamazepine and divalproex, your doctor will need to test your liver now and
then to see how well it's working. If you are taking lithium, your doctor may
also test your thyroid and kidneys.
Mood stabilizers may interact
with other medicines. Tell your doctor all of the medicines you are taking and
ask about possible interactions.
FDA advisory. The U.S. Food and Drug
Administration (FDA) has issued a warning on antiseizure medicines and the risk
of suicide and suicidal thoughts. The FDA does not recommend that people stop
using these medicines. Instead, people who take antiseizure medicine should be
watched closely for
warning signs of suicide. People who take antiseizure
medicine and who are worried about this side effect should talk to a doctor.
National Institute for Health and Clinical Excellence (2009). Borderline personality disorder: Treatment and management. London: National Institute for Health & Clinical Excellence (NICE). Available online: http://publications.nice.org.uk/borderline-personality-disorder-cg78.
March 8, 2013
Sarah Marshall, MD - Family Medicine
& Lisa S. Weinstock, MD - Psychiatry
How this information was developed to help you make better health decisions.
To learn more visit Healthwise.org
© 1995-2013 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.
We are happy to take your appointment request over the phone, or, you may fill out an online request form.
Disclaimer: The information on this website is for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, evaluation or care from your physician or other qualified health care provider.