The common side effects of mood stabilizers — and when to see a doctor

• Some common side effects of mood stabilizers include tremors, nausea, and dizziness. 
• Mood stabilizer side effects that you should see a doctor for are loss of balance, extreme drowsiness, and rapid heart rate.
• While mood stabilizers can cause adverse side effects, do not stop taking your medication. Instead, reach out to a doctor to see if you can adjust your dose.
• This article was medically reviewed by David A. Merrill, MD, PhD, psychiatrist and director of the Pacific Brain Health Center at Pacific Neuroscience Institute at Providence Saint John’s Health Center.
• Visit Insider’s Health Reference library for more advice. 

Mood stabilizers are a class of drugs used to prevent and reduce mood episodes such as mania and depression. Like any medication, there are both benefits and risks of taking mood stabilizers. Here are the common side effects of mood stabilizers and when you should seek medical attention.   

What are mood stabilizers? 

Mood stabilizers are most often used to treat bipolar disorders — such as bipolar 1 or 2. However, they can also be used to treat mood symptoms that occur in other mental health conditions, says Ruth Levine, MD, a professor of psychiatry and internal medicine at the University of Texas Medical Branch in Galveston, Texas. These include schizoaffective disorder and depression. 

How effective mood stabilizers are in managing symptoms varies amongst individuals. “Sometimes recovery means the person no longer experiences mood episodes, and for some, it may just mean that these episodes are less frequent,” says Crystal Clark, MD, MSc, an associate professor of psychiatry and behavioral sciences and obstetrics and gynecology at Northwestern University. 

Mood stabilizers work by decreasing the abnormal brain activity responsible for mood symptoms. Levine says that mania happens when the brain is running on overdrive, whereas depression is essentially the opposite. 

Mood stabilizers help restore brain activity to normal levels. However, the exact way these medications work in the brain is unknown. “We know there are results with these medications, but we don’t know the mechanisms,” says Clark.

Mood stabilizer side effects 

The side effects experienced with mood stabilizers can vary depending on the person and type of medication. 

Here are some side effects associated with common mood stabilizers according to Clark and Levine. 

Not everyone will experience side effects while taking mood stabilizers, but it is common to experience some, says Levine — adding that "most side effects are tolerable."

A 2015 study published in a European medical journal found that in a sample group of people taking the common mood stabilizer Carbamazepine 31.3% experienced drowsiness and 26.6% experienced nausea and dizziness. 

Clark says that some of the side effects may go away once your body adjusts to the medication, but others may persist the entire time you are taking the drug. For example, when taking lithium symptoms that may subside include acne, feeling bloated, lost libido, and diarrhea. "But it's likely you will experience tremors the entire time you are on the medication," Clark says.  

When to see a doctor 

It's important to maintain open communication with your doctor while taking mood stabilizers since some of the side effects could be signs and symptoms of more serious health problems. 

Clark says you should seek medical help if you experience the following symptoms:

• Change in vision
• Extreme drowsiness
• Loss of balance when standing on two feet 
• Rapid heart rate

"If side effects are sufficient to be interfering with your personal or professional life, you should seek medical help," says Levine. 

Stick to your medication

Sometimes people forego taking their medication because of the adverse side effects. However, it is important for people that take mood stabilizers to stay on their medication to avoid mood episode relapses. 

People with bipolar disorder have an approximately 50% rate of medication nonadherence. This is when you either stop taking your medication or don't take the medication the way that your doctor prescribed it to you.

Some reasons why people with bipolar disorder don't adhere to their prescribed medication.

• Negative attitudes about taking the medication 
• Lack of understanding of how the medication will help them
• Complexity of medication regimen 
• Side effects associated with medication 

You should always talk to your healthcare provider before making any changes to how you take your medication.

Clark says that mood stabilizers can take anywhere from two to four weeks to be effective. So, if you do stop taking your medication before or during this time frame, you may not experience any relief from mood symptoms. In some instances, it can even delay your recovery process.

For example, people that are prescribed Lamotrigine start by taking low doses and slowly build to higher, more effective doses. If you stop taking Lamotrigine in the middle of this process, you will have to start all over again with a low dose.

People with bipolar disorder that abruptly stop taking their medication are at a higher risk for relapse because "bipolar disorder tends to be progressive," says Levine. This means that over time, mood episodes will increase in frequency and intensity. Mood stabilizers help prevent the progression of the illness, so it is important to stay on them to make sure your symptoms don't get worse. 

Managing side effects

Your doctor can also give you information that will help manage any side effects you may experience while on these drugs. 

Some steps your doctor may take to help you manage your symptoms are:

• Adjust your dose of medication 
• Suggest you take the medication at a certain time of day or with food
• Prescribe another medication to help control the side effects
• Change the type of mood stabilizer you are taking

Takeaways 

Mood stabilizers come with a range of side effects, and it's common to experience some. Though, the side effects should not be so severe that they impair your quality of life. 

It's important to remember that if you experience intolerable side effects with one type of mood stabilizer, it doesn't mean you will not be able to find a treatment that works for you. 

"Don't give up because not all medications are the same," says Clark. The first medication you take to treat your condition may not be the right one. 

Keep an open dialogue with your doctor so they can help you figure out what treatment plan will be the best fit for you.