Guide To The Side Effects Of Mood Stabilizers

October 10, 2023

Mood stabilizers are a class of medications typically used to treat bipolar disorder. Many of them have additional uses in other mental and physical health disorders, but the alternative usage varies depending on the medication. In bipolar disorder, a patient experiences extreme highs and extreme lows. The highs are called mania, and the lows are called depression. Mood stabilizers are one of the most important treatments for bipolar disorder. They curb the highs and lows to help a patient's mood reach an equilibrium. Many of the first-line medications used for major depressive disorder can make bipolar disorder worse. For example, selective serotonin reuptake inhibitors can cause a bipolar disorder patient to rapid cycle through moods unless they have a mood stabilizer alongside the medication.

Understanding the side effects of mood stabilizers is important to establish an effective treatment plan. Reveal the details on this now.

Nausea And Vomiting

Nausea and vomiting are common side effects of mood stabilizers, though not all of them will cause them. If a patient tries a mood stabilizer, and it causes enough nausea to cause them to want to discontinue it, they should talk to their doctor about alternatives. In the past, there weren't many mood stabilizers available. But over the past few decades, many more mood-stabilizing medications have been developed, so the range of options has broadened. Some medications are meant to be taken with meals, and they can cause nausea or vomiting if patients take them on an empty stomach. Some medications are meant to be taken about twenty to thirty minutes after eating. Patients must always talk to their doctor and pharmacist to find out when they're supposed to take the medication and whether they need food with it. Severe, debilitating nausea shouldn't happen with an ideal mood stabilizer combination. While it doesn't necessarily mean they're experiencing dangerous side effects, it does mean a medication adjustment is probably in order.

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Blurred Vision

Blurred vision is a potential side effect of certain mood stabilizers. Not all of them lead to blurry vision, but some have the potential to. While blurry vision isn't always a cause for serious concern, and the problem can often be rectified with reading glasses, patients should see a doctor if their vision sharply declines or the blurriness interferes with day-to-day life. Lithium is the oldest mood-stabilizing medication for bipolar disorder, but it can cause blurry vision because of how it impacts the function of an individual's pupils. The effects on a patient's vision most commonly fade after treatment with the lithium continues. If any side effects are severe, including blurry vision, patients should immediately talk to their doctor. Divalproex is an anticonvulsant medication sometimes used as a mood stabilizer, though it can also lead to blurred vision and nausea. Like Divalproex, carbamazepine is a mood-stabilizing anticonvulsant that might cause blurry vision. This medication tends to have more severe common side effects than Divalproex.

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Drowsiness can occur alongside a great number of mood stabilizers. In addition, drinking alcohol with a mood stabilizer increases the side effects of both. Patients are more likely to experience dizziness, drowsiness, and nausea when combining alcohol and mood stabilizers than consuming either on their own. In most cases, the drowsiness wears off after the patient has taken the mood stabilizer for a few weeks or months. If the tiredness is impairing the patient's day-to-day function, they need to talk to their doctor about it. The mood stabilizer shouldn't be leaving patients feeling tired, weak, empty, or like they don't have enough energy to get through the day. Patients shouldn't feel like they have to nap in the middle of the day to function, or like they need to drink caffeine to get by. Caffeine can have a negative effect on bipolar disorder to begin with, so it's best to limit it. If patients are taking a new medication that might cause drowsiness, and they don't yet know how it affects them, they should be careful driving their car or doing other potentially dangerous activities.

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Dizziness can often accompany drowsiness and other issues with a lack of coordination, though it might also appear as a side effect by itself. Patients might experience sudden fits of dizziness without any apparent warning. It might be hard to balance, and they might hear a ringing in their ears and feel like they might faint. Patients might also feel like the world is tilting underneath them. Some individuals experience dizziness without any rhyme or reason, though others can detect patterns to it. For example, individuals might become dizzy if they stand up for too-long periods and become fatigued. They might also get suddenly dizzy if they rise from a sitting or laying-down position, which can sometimes cause their blood pressure to drop. A severe enough drop in blood pressure will keep your brain from getting enough oxygenated blood, which can cause them to blackout. If patients experience any dizzy spells severe enough to cause fainting, they should talk to their doctor about ways to adjust or change their medication.

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Muscle Tremors

The majority of muscle tremors due to mood stabilizers resolve within a few weeks or months after stopping the medication. Some patients experience tremors for up to eighteen months after their last dose. In extreme and rare cases, tremors from mood stabilizers can be permanent, even after the medication has stopped. Tremors in the hands tend to be small and barely noticeable, and for most patients, they don't interfere strongly in day-to-day life. However, some patients might struggle to do crafts and activities that require steady hands. It might be hard to thread a needle, paint fine details, or engage in other motions that can't be done while the hands are shaking. If individuals experiencing a tremor as a result of a mood stabilizer, and it's interfering with their day-to-day life, they must speak to their doctor.

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Liver Damage

Liver damage is a relatively rare potential side effect associated with specific mood stabilizers such as carbamazepine, divalproex sodium, and topiramate. Patients may have changes in liver enzymes and liver function tests, and instances of fatal liver failure have been reported. Patients who have liver damage could experience jaundice, abdominal pain or swelling, skin itching, dark-colored urine, and pale or bloody stools. There may also be a tendency to bruise easily, and the patient might notice swelling in the legs and ankles. Individuals who take mood stabilizers may need to have liver function tests before and during treatment, and they should report any possible symptoms of liver damage to their physician immediately. In some cases, liver damage may be reversible if the mood stabilizer that causes the symptoms is stopped. Patients with pre-existing liver conditions should let their doctor know before a mood stabilizer is prescribed.

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Hair Loss

Patients who take mood stabilizers may experience hair loss. This side effect tends to occur more frequently in patients who take divalproex sodium. Individuals may notice they have more shedding while brushing or styling their hair. Some patients might develop small patches of thinning hair, and the scalp may have bald spots. Since hair loss can be caused by many types of medical conditions, individuals experiencing this symptom may wish to have a physical examination and laboratory tests to determine the underlying cause. Patients should also mention their hair loss to their healthcare provider. It may be possible that trying a new mood stabilizer leads to an improvement. To minimize hair loss, patients may want to avoid exposing their hair to heated styling products and chemical relaxants, and it could be helpful to use a soft hairbrush and minimize hair brushing to reduce shedding.

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Weight Gain

Weight gain is a very common side effect of most mood stabilizers, especially lithium, divalproex sodium, and valproic acid. Roughly twenty-five percent of those taking lithium will experience weight gain with long-term treatment, and the amount gained usually ranges from 4.5 to twelve kilograms. Doctors believe fluid retention, increases in appetite, polydipsia, and subclinical hypothyroidism triggered by lithium use may all contribute to weight gain for these patients. Studies suggest valproate users may gain three to ten kilograms over three to twelve months, and one study reported weight gain of twenty-one kilograms over seven years of using this medicine. Valproate use may cause some female patients to develop polycystic ovarian syndrome, and this could lead to weight gain as well.

Research conducted on gabapentin users found the medication was associated with an average weight gain of 0.9 to three kilograms over twelve weeks, and carbamazepine is associated with moderate weight gain. Patients who take mood stabilizers with antipsychotics such as risperidone and olanzapine have a significantly increased chance of gaining weight. Currently, lamotrigine is one of the only mood stabilizers not associated with weight gain. Patients taking mood stabilizers may need to have their weight monitored frequently, and it may be necessary to have professional help from doctors and nutritionists to maintain a healthy weight and avoid weight-related complications.

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Increased Sensitivity To The Sun

Patients who take mood stabilizers may notice an increased sensitivity to the sun, and this side effect is common with carbamazepine. Increased sensitivity to the sun could cause individuals to experience skin redness or sunburns with minimal sun exposure. The skin could become painful, and it may peel. To reduce this risk, patients should apply sunscreen on a daily basis, and it needs to be applied to all exposed areas of the body, including the face, ears, neck, chest, and feet. Wearing special clothing designed to block the sun's rays may be helpful as well, and patients should also wear a hat and sunglasses. If possible, wearing long-sleeved shirts is advisable. Patients should ideally stay indoors between 10 a.m. and 4 p.m. If severe sunburn occurs, the patient should seek urgent care. Patients may also wish to see a dermatologist for a yearly skin examination to reduce the risk of skin cancer. In cases where sun sensitivity interferes with an individual's daily life, the prescribing physician might recommend switching to another drug that does not cause this side effect.

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Kidney Damage

Kidney damage associated with the use of mood stabilizers is most commonly linked to lithium. Damage to the kidneys may lead to kidney disease. A Danish study published in November 2015 revealed short-term use of this medication doubled an individual's risk of kidney disease. Specifically, the risk increased from one to 2.5 percent, and the risk of developing end-stage kidney disease also increased. The same study concluded that long-term use of lithium raised an individual's kidney disease risk from one percent to three percent; however, long-term use was not associated with an increase in the development of end-stage kidney disease. Patients who take lithium will have regular kidney function tests during treatment, and they should be aware of potential indicators of kidney disease. These generally include nausea, vomiting, sleep disturbances, persistent skin itching, loss of appetite, fatigue, and high blood pressure. The patient might also notice changes in how much they urinate. Individuals who observe any of these symptoms should see their doctor as soon as possible.

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