103. Mood Stabilizers

  1. Allan Tasman Professor Chair3,
  2. Jerald Kay Professor Chair4,
  3. Jeffrey A. Lieberman Lawrence Kolb Professor Chairman Director Psychiatrist in Chief5,6,7,
  4. Michael B. First Professor of Clinical Psychiatry5,6,8 and
  5. Mario Maj Professor Chair9
  1. David J. Muzina1,
  2. David E. Kemp2 and
  3. Joseph R. Calabrese2

Published Online: 8 AUG 2008

DOI: 10.1002/9780470515167.ch103

Psychiatry, Third Edition

Psychiatry, Third Edition

How to Cite

Muzina, D. J., Kemp, D. E. and Calabrese, J. R. (2008) Mood Stabilizers, in Psychiatry, Third Edition (eds A. Tasman, J. Kay, J. A. Lieberman, M. B. First and M. Maj), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/9780470515167.ch103

Editor Information

  1. 3

    Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY, USA

  2. 4

    Department of Psychiatry, Wright State University Boonshoft School of Medicine, Dayton, OH, USA

  3. 5

    Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA

  4. 6

    New York State Psychiatric Institute, New York, NY, USA

  5. 7

    Columbia University Medical Center, New York – Presbyterian Hospital, New York, NY, USA

  6. 8

    Department of Psychiatry, Columbia University Medical Center, New York, NY, USA

  7. 9

    Department of Psychiatry, University of Naples, Naples, Italy

Author Information

  1. 1

    Department of Psychiatry and Psychology, Cleveland Clinic Neurological Institute, Cleveland, OH, USA

  2. 2

    Department of Psychiatry, Case Western Reserve University and University Hospitals, Cleveland, OH, USA

Publication History

  1. Published Online: 8 AUG 2008
  2. Published Print: 16 APR 2008

ISBN Information

Print ISBN: 9780470065716

Online ISBN: 9780470515167

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Keywords:

  • mood stabilizers;
  • bipolar disorder;
  • lithium;
  • lamotrigine;
  • divalproex;
  • valproate;
  • aripiprazole;
  • risperidone;
  • olanzapine;
  • quetiapine;
  • ziprasidone;
  • olanzapine–fluoxetine combination

Summary

Pharmacological treatment of bipolar disorder has centered on the use of medications called ‘mood stabilizers.’ However, this term is not well understood or defined. This chapter discusses the debate about mood stabilizers in the context of a review of evidence for various medications used to treat bipolar mania, bipolar depression, and in the maintenance treatment of this chronic and recurrent affective illness. Based on existing evidence it appears that there are no ideal or fully effective mood stabilizers currently available, including lithium. Lithium, antiepileptic drugs (AEDs) such as lamotrigine, carbamazepine, and divalproex, and atypical antipsychotic medications all appear to have some partial role in the overall management of bipolar disorder with particular phase-specific strengths and weaknesses. Reconceptualization of mood stabilizers is suggested, noting that currently available medications are all partial mood stabilizers. These partial mood stabilizers possess efficacies that may be described as unidirectional, bidirectional, intermediate, or mixed. It is hoped with future research and understanding of the underlying pathophysiology of bipolar disorder that more complete; ideal mood stabilizers may be developed. Until such time, clinicians must utilize the best available evidence for the partial mood stabilizers to formulate individualized mood stabilizing treatment plans for each unique patient with bipolar disorder.