Mood Stabilizer Medications

Mood Stabilizer Medications: Depakote

bipolar-treatment

Depakote is the trade name of a coated form of divalproex sodium. It has been shown to be effective therapy for preventing the recurrance of manic and depressive episodes in bipolar disorder and is thought to work by diminishing neurological kindling effects. The coated form (Depakote) is desgined to be less likely to cause nausea.

Leukopenia or Low Number of White Blood Cells

Some people who take Tegretol or Depakote will experience a reduction in the number of white blood cells in their body. Low levels of white blood cells can be a problem because white blood cells help fight infection and having fewer white blood cells can make you more susceptible to infection. Your doctor may take blood tests to monitor the number of white blood cells in your body to ensure that they do not drop too low.

Liver Problems

On very rare occasions, a medication can irritate the liver and produce inflammation. The symptoms of liver irritation include extreme tiredness, severe nausea, and yellowing of the whites of the eyes and skin. If you notice any of these symptoms beginning to develop, call your doctor immediately. Your doctor will evaluate your symptoms and modify your prescription accordingly.

Mood Stabilizer Medications: Lithium

The mood swings of bipolar disorder can usually be reduced and controlled by taking lithium. Lithium is a pure element that occurs naturally in your body. Most people taking lithium take it in a form called lithium carbonate, but other formulations (such as lithium citrate) exist. Lithium is effective for 60-80% of bipolar patients who try it and has been shown to reduce the frequency, severity, and duration of both mania and depression in bipolar patients. It is somewhat better at controlling mania than it is at controlling depression. It takes 7 to 14 days to see the full effect of lithium.

Swelling of the Thyroid Gland

Some patients will develop a diffuse, painless swelling of the thyroid gland in their neck along with lower levels of thyroxin, a hormone produced by the thyroid gland. This is known as hypothyroidism and can occur at any time but is especially likely to occur early in treatment. This may happen because lithium interferes with the thyroid’s ability to use iodine. Actual thyroid damage is very rare. 5-15% of persons on long-term Lithium treatment develop hypothyroidism. This effect is more common in post-menopausal women. If the swelling is severe, your doctor can prescribe thyroid replacement hormones. As there is very rarely any actual thyroid damage, the symptoms should disappear completely after you stop taking Lithium. If you begin to notice this happening to you, talk to your doctor about it.

Increased Urination

Increased-Urination

Rarely, persons taking lithium may develop serious problems with increased urination (up to four liters per day). Lithium can also decrease the rate at which the kidney filters blood, causing a condition doctors call glomerulonephritis. Urine tests can detect this condition by looking for proteins and enzymes that are not normally found in urine. About 5-10% of persons on long-term lithium use may develop late polyuria but developing glomerulonephritis from lithium is rare. Talk with your doctor if you are concerned about this risk. Sometimes this side effect will lessen when the dose is changed. This condition reserves itself when lithium is discontinued. Sometimes your doctor will prescribe a diuretic to counteract polyuria. (Although a diuretic is normally used to encourage urination, sometimes diuretics are good treatments for this type of polyuria.) Most experts believe that this change in kidney function is temporary and will disappear after a person stops taking lithium.

Overactive Parathyroid Gland

Long-term lithium patients may develop elevated levels of parathyroid hormone, which may increase levels of calcium in your body. These higher levels may make it appear as if you have an overactive parathyroid gland, a condition doctors call hyperparathyroidism. Normally, these elevated levels will not have a noticable effect, but very high levels of calcium can cause lethargy, bad moods, and poor coordination. In persons taking lithium for bipolar disorder, however, there is some uncertainty about whether these symptoms are the result of high calcium levels or of the underlying depression. Elevated calcium and parathyroid hormone levels occur in 10-15% of persons taking lithium for over four weeks. In most patients, these elevated levels are clinically insignificant and do not last. These effects will also reverse on discontinuation of the drug. If you think that any of these descripions apply to you, talk to your doctor about them.

Arrhythmia

Arrhythmia

Some patients will develop changes in the shape of their heartbeat wave when seen on an electrocardiogram (ECG) . This is known as a T-wave depression. These changes are harmless and are unlikely to result in any noticable change except and occasional heartbeat irregularities (arrhythmia). Approximately 25% of persons taking lithium develop T-wave depressions. This does not normally require treatment. However, if you are concerned, or think that there may be a more serious problem, talk to your doctor. He/she will be able to help you.

Parkinsonism

This is a group of side effects that look like the symptoms seen in Parkinson’s Disease. However, having these side effects does not mean you have Parkinson’s Disease. The Parkinsonian side effects include cogwheel rigidity, muscle stiffness, shuffling gait, stooped posture, and mask-like appearance of the face.

Your doctor can give you other medicines to decrease these side effects or possibly make changes in the amount of your medication.

Mood Stabilizer Medications: Tegretol

Tegretol (which also goes by the generic name carbamazepine) has been shown to be effective therapy for preventing manic depressive episodes in bipolar disorder. It appears to be especially useful for persons who have rapid cycling and mixed state features, who are often less likely to respond to lithium. Tegretol is thought to work by dampening the cycle of increasingly common episodes in bipolar disorder (sometimes called a kindling effect).

Leukopenia or Low Number of White Blood Cells

Some people who take Tegretol or Depakote will experience a reduction in the number of white blood cells in their body. Low levels of white blood cells can be a problem because white blood cells help fight infection and having fewer white blood cells can make you more susceptible to infection. Your doctor may take blood tests to monitor the number of white blood cells in your body to ensure that they do not drop too low.

Aplastic Anemia

Aplastic-Anemia

Very rarely, some persons on Tegretol develop a condition known as aplastic anemia, in which the production of blood cells in their bones is seriously compromised. Patients with aplastic anemia will look pale, feel short of breath, and/or have a lack of energy. However, many things–including other types of anemia–can cause these effects. Your doctor will probably choose to take blood tests before and during treatment to watch for this possibility. This complication happens to fewer than 1 in every 200,000 persons treated with Tegretol. Aplastic anemia is a serious, life-threatening condition that will require extensive medical intervention. If you are concerned about this risk, talk to your doctor.