Lithium and other mood stabilisers

Explains what mood stabilising drugs are, what they're used for, possible side effects and information about withdrawal.

Why might I be offered a mood stabiliser?

Your doctor's decision to offer you a mood stabiliser is likely to depend on:

  • your diagnosis and the symptoms you experience
  • your past experiences of taking medication, including what's worked for you and what hasn't (for example, if you've tried lithium and had lots of problems with it, your doctor could offer you a different mood stabiliser instead)
  • your medical circumstances (for example, if you are pregnant or breastfeeding or have a history of kidney or thyroid problems)
  • what you want (see our pages on seeking help for a mental health problem for information on having your say in decisions, and making yourself heard)

Before you take any medication

Before you decide to take any medication, you should make sure you have all the facts you need to feel confident about your decision. For guidance on the basic information you might want to know about any drug before you take it, see our pages on:

Which mood stabiliser is right for me?

The drugs that can be prescribed as mood stabilisers have different potential advantages and disadvantages. For example:

  • lithium can be a very effective treatment for mania, but is less effective at treating severe depression. You might be offered lithium if you have a diagnosis of bipolar I (characterised by manic episodes).
  • carbamazepine (Tegretol) and valproate (Depakote, Epilim) are comparatively effective in treating:
    • mixed episodes of mania and depression (feeling low and high at the same time)
    • rapid cycling between mania and depression
    • very severe mania with psychosis
    • additional anxiety disorders or substance abuse
    • symptoms that occur after neurological illness or brain injury
    • people who have little or no family history of bipolar disorder
  • lamotrigine (Lamictal) has antidepressant effects and is licensed to treat severe depression in bipolar disorder. You might be offered lamotrigine if you have a diagnosis of bipolar II (characterised by severe depressive episodes alternating with hypomania).
  • asenapine (Sycrest) is specifically licensed to treat mania in bipolar disorder. You might be offered asenapine if other mood stabilisers aren't right for you.

"I have a form of bipolar which cycles very quickly, but I'm not psychotic. I was prescribed valproate in a controlled release tablet… It's changed my life."

Might I need to take other medication as well?

Depending on your diagnosis and the problems you experience, your doctor might suggest that a combination of a mood stabiliser and another drug might be the best way to manage your symptoms. In this case, they might decide to offer you other kinds of medication as part of your treatment, such as:

"I can't imagine ever being off them, and when I miss a dose I completely lose it. I will always be eternally grateful for the medication I’m on."

(To learn more about available treatments for bipolar disorder, manic episodes and depression, see our pages on treatments for bipolar disorder, treatments for mania and hypomania, and treatments for depression.)

Could a mood stabiliser make me feel worse?

It's important to remember that all drugs can affect different people differently.

Although many people find that the benefits of taking a mood stabiliser outweigh any negatives, not everybody does – and your experience will be personal to you. (For ideas to help manage your mood without drugs, see our page on alternatives to mood stabilisers.)

"I have a total distrust of mood stabilisers ... I can’t be doing with the side effects – they flatten my personality and prevent me doing the creative things I love."

All these drugs also have the potential to cause unwanted side effects, or withdrawal effects if you choose to stop taking them. (To learn about about the possible side effects and withdrawal effects these drugs can cause, see our individual pages on lithium, valproate, carbamazepine, lamotrigine and asenapine).

This information was published in February 2015. We will revise it in 2019.

References are available on request. If you would like to reproduce any of this information, see our page on permissions and licensing.

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