What we’ve said about Mood stabilizers

“That's how I define it. So it treats or prevents episodes of bipolar without flipping someone into the opposite pole”

“The ones that I include, I think you might actually include more mood stabilizers in this category. But I consider it's lithium, Depakote, Lamotrigine, carbamazepine, and oxcarbazepine”

“Lamotrigine. which is the weakest, but also probably the best tolerated. We have lithium, which is the gold standard, the classic. And we have Depakote. Works great. There are some problems with it, especially with both male and female fertility”

“The truth is, anything that's going to decrease the excitability of the brain, to me, intuitively, it makes sense. It's going to have some impact on bipolar”

“simplified social rhythm therapy is my number one mood stabilizer and then lamotrigine and low-dose lithium”

“mood stabilization is king. Yes, it's much easier for patients to avoid the labs, for you to avoid the headache of the labs, and the side effects sound scarier on mood stabilizers and antipsychotics, but please do the mood stabilization first”

“My answer to bipolar disorder is mood stabilizer. My answer to bipolar disorder not responding to one mood stabilizer is not antipsychotic. It's two mood stabilizers. So do not neglect the mood stabilizers”

“The biggest one for sure is how likely is it that we're going to make you worse with an antidepressant? And conversely, to the extent that we worry about that, then we think that maybe a mood stabilizer based approach is a better idea”

“Which are the MSAEs? This I thought was where you were going with the Ls. Three Ls and a Q for the mood stabilizers with antidepressant efficacy. I missed trazodone. Lithium, lamotrigine, trazodone, and we have to put quetiapine on there”

“if you have any schizophrenia spectrum disorder and you have any hint of mood problems on either pole, add a mood stabilizer. If it's agitation, probably try Depakote first along with impulsivity. That may help. And if it's anything else, lithium, lithium, lithium”

“make a greater effort to add mood stabilizers to antipsychotic regimens, even dual Antipsychotic regimens that people have been on for a long time. If you do that when it's indicated, you are going to find significant improvements in some patients that you just can't achieve using the antipsychotic class”

“do not be afraid also to use mood stabilizers. We don't understand these categories as much as we think. And I think the reality is that there's probably a lot of genetic and pathophysiological crossover between the bipolar disorders and the schizophrenia and sometimes OCD, ADHD, autism”

“But since learning about that, whenever I've heard a patient has had recurrent mood episodes and I see a lot of the previous medication trials haven't worked, I really make sure that there's been a mood stabilizer trial at some point”

“Please seek mood stabilization primarily, even if you don't have clear mood symptoms remaining. If you have any problems with the sleep, you might benefit broadly from more mood stabilization or lifestyle changes and different skills”

“I usually do a combination treatment. I think of three main things. So the mood stabilizer, I want to solve that and I want to start it. Whatever one we can get on. But I also know that that one's going to take some time to work”

“SSRIs can help with some of the anxiety and the depression. But of course, it's not going to fix the core issue. And one of the big goals of treatment is to be connecting the symptoms to the interpersonal problems”

“the onset of effect of lithium takes at least two weeks most of the time. So that's the problem with the mood stabilizers. I think that's why a lot of people don't use them today, because they want instant gratification as a clinician and a patient. You have to set expectations”

“The mood stabilizers decrease the number of episodes. Yes, it helps with depression but it's very slow. Yes, it helps with mania but it's pretty slow. The reason why I find treating bipolar so fun is because you say we're playing the long game”

“if you don't tell people that, then it's very normal for them to say, wow, I'm taking this mood stabilizer. I feel tired and depressed. I should stop it”

“But I say to people with bipolar disorder and to the clinicians, please give the mood stabilizers a fighting chance. You may find that things go better for you body health wise, mind health wise in the long term”

“I do think people should be at least thinking of mood stabilizers more often. You should at least be thinking of mood stabilizers more often. At least in my area, I think they are disgustingly under-prescribed”

“I think you really need to have at least some evidence of like a, you know, neurobiological type depression where there's episodes or stark changes in total functioning rather than simple mood or reactivity between human beings, interpersonal issues”

“I acknowledge the evidence-based that suggests those subtypes and those matching medications. We feel the same. I don't really subscribe to it. I feel like it's selection bias”

“They've talked about using mood stabilizers. I have not found that to be terribly helpful. Only the non-traditional mood stabilizers, not really mood stabilizers, Topamax and Gabapentin, I think, are more usable”

“whenever you're talking to a bipolar specialist, they emphasize the importance of mood stabilizers. And you'll see as you treat more and more patients, you start to use antidepressants less and you focus the mainstay of treatment on mood stabilizers, mood stabilizers, mood stabilizers”

“I have my usual message, you know, call it whatever you want, but just give the right treatment. And if your mood stabilizer is helping, maybe they do need a mood stabilizer”

“they may have those personality tendencies, but without the added weight of a untreated mood disorder, it doesn't really come out with the same severity. So you got to have nuance and you have to monitor or treat and, you know, think over time”

“Do you really want to treat that with a mood stabilizer or an antipsychotic? Probably not, but there is a risk in some patients with mood temperaments that they actually do develop full-blown mood disorders”