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Journal articles on the topic 'Mood stabilizer'

Author: Grafiati

Published: 4 June 2021

Last updated: 10 February 2022

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1

Gould, Todd D., Guang Chen, and Husseini K. Manji. "Mood stabilizer psychopharmacology." Clinical Neuroscience Research 2, no. 3-4 (December 2002): 193–212. http://dx.doi.org/10.1016/s1566-2772(02)00044-0.

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2

Ghaemi, S. Nassir. "On defining ‘mood stabilizer’." Bipolar Disorders 3, no. 3 (June 2001): 154–58. http://dx.doi.org/10.1034/j.1399-5618.2001.030304.x.

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3

Maidment, Ian D. "The Use of Topiramate in Mood Stabilization." Annals of Pharmacotherapy 36, no. 7-8 (July 2002): 1277–81. http://dx.doi.org/10.1345/aph.1a398.

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OBJECTIVE: To review data on the effectiveness of topiramate as a mood stabilizer. DATA SOURCES: Clinical literature accessed through MEDLINE (1985–September 2001) and the manufacturer. Key search terms included topiramate, mania, mood stabilizer, and bipolar disorder. DATA SYNTHESIS: The traditional standard therapy for bipolar disorder has been lithium. Other mood stabilizers are increasingly being used to manage this complex disorder. Studies that used topiramate in bipolar disorders were evaluated. CONCLUSIONS: The present data from open trials suggest that topiramate may possibly possess antimanic properties. Controlled, double-blind studies are required to confirm this efficacy.

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4

Burghardt, Kyle, Kristen Ward, Elani Sanders, Bradley Howlett, Berhane Seyoum, and Zhengping Yi. "Atypical Antipsychotics and the Human Skeletal Muscle Lipidome." Metabolites 8, no. 4 (October 13, 2018): 64. http://dx.doi.org/10.3390/metabo8040064.

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Atypical antipsychotics (AAPs) are a class of medications associated with significant metabolic side effects, including insulin resistance. The aim of this study was to analyze the skeletal muscle lipidome of patients on AAPs, compared to mood stabilizers, to further understand the molecular changes underlying AAP treatment and side effects. Bipolar patients on AAPs or mood stabilizers underwent a fasting muscle biopsy and assessment of insulin sensitivity. A lipidomic analysis of total fatty acids (TFAs), phosphatidylcholines (PCs) and ceramides (CERs) was performed on the muscle biopsies, then lipid species were compared between treatment groups, and correlation analyses were performed with insulin sensitivity. TFAs and PCs were decreased and CERs were increased in the AAP group relative to those in the mood stabilizer group (FDR q-value <0.05). A larger number of TFAs and PCs were positively correlated with insulin sensitivity in the AAP group compared to those in the mood stabilizer group. In contrast, a larger number of CERs were negatively correlated with insulin sensitivity in the AAP group compared to that in the mood stabilizer group. The findings here suggest that AAPs are associated with changes in the lipid profiles of human skeletal muscle when compared to mood stabilizers and that these changes correlate with insulin sensitivity.

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5

McKinney, Parish, Ryan Finkenbine, and C. Lindsay DeVane. "Alopecia and Mood Stabilizer Therapy." Annals of Clinical Psychiatry 8, no. 3 (September 1, 1996): 183–85. http://dx.doi.org/10.3109/10401239609147756.

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6

GOODWIN, GUY M., and GIN S. MALHI. "What is a mood stabilizer?" Psychological Medicine 37, no. 05 (December 13, 2006): 609. http://dx.doi.org/10.1017/s0033291706009305.

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7

Tohen, M., T. Jacobs, V. Toma, J. Francis, F. Zhang, K. S. Gannon, T. M. Sanger, and A. Breier. "Is olanzapine a mood-stabilizer?" Schizophrenia Research 41, no. 1 (January 2000): 193–94. http://dx.doi.org/10.1016/s0920-9964(00)90774-6.

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8

Maidment, Ian D. "Lamotrigine — An Effective Mood Stabilizer?" Annals of Pharmacotherapy 33, no. 7-8 (July 1999): 864–67. http://dx.doi.org/10.1345/aph.18388.

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9

Letmaier, M., D. Schreinzer, R. Wolf, and S. Kasper. "Topiramate as a mood stabilizer." International Clinical Psychopharmacology 16, no. 5 (September 2001): 295–98. http://dx.doi.org/10.1097/00004850-200109000-00008.

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10

Tohen, M. F., T. G. Jacobs, P. D. Feldman, V. Toma, B. J. Francis, F. Zhang, T. M. Sanger, and A. Breier. "275. Is olanzapine a mood-stabilizer?" Biological Psychiatry 47, no. 8 (April 2000): S83. http://dx.doi.org/10.1016/s0006-3223(00)00539-4.

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11

Ketter, Terence A. "Definition of the term “mood stabilizer”." Bipolar Disorders 20, no. 1 (December 7, 2017): 74–75. http://dx.doi.org/10.1111/bdi.12579.

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12

LOVELL, R. WALTER. "Mood Stabilizer Combinations for Bipolar Disorder." American Journal of Psychiatry 156, no. 6 (June 1999): 980a—980. http://dx.doi.org/10.1176/ajp.156.6.980a.

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13

Safer, Daniel J. "Mood swing and mood stabilizer: how specific are these terms?" Bipolar Disorders 12, no. 7 (October 29, 2010): 685–90. http://dx.doi.org/10.1111/j.1399-5618.2010.00870.x.

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14

Momtazi, S. "Topiramate as a mood stabilizer for epilepsy comorbid with mood disorders." European Neuropsychopharmacology 12 (October 2002): 239. http://dx.doi.org/10.1016/s0924-977x(02)80295-4.

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15

Yatham, L., C. Binder, V. Kusumakar, and R. Riccardelli. "Risperidone added to mood stabilizers in mania; is there a difference in effect depending on mood stabilizer?" European Neuropsychopharmacology 12 (October 2002): 202. http://dx.doi.org/10.1016/s0924-977x(02)80202-4.

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16

Wang, J. F., X. J. Sun, and L. T. Young. "197. Regulation of mood stabilizer regulated genes." Biological Psychiatry 47, no. 8 (April 2000): S60. http://dx.doi.org/10.1016/s0006-3223(00)00282-1.

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17

Rybakowski, Janusz K. "Meaningful aspects of the term ‘mood stabilizer’." Bipolar Disorders 20, no. 4 (January 12, 2018): 391–92. http://dx.doi.org/10.1111/bdi.12608.

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18

Grossman, F., C. Bowden, and A. Okamoto. "Risperidone plus mood stabilizer versus placebo plus mood stabilizer in patients with bipolar disorder: A combined efficacy analysis." European Neuropsychopharmacology 11 (January 2001): S254. http://dx.doi.org/10.1016/s0924-977x(01)80294-7.

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19

Bauer, M., N. Rasgon, P. Grof, T. Glenn, M. Lapp, W. Marsh, R. Munoz, et al. "Do antidepressants influence mood patterns? A naturalistic study in bipolar disorder." European Psychiatry 21, no. 4 (June 2006): 262–69. http://dx.doi.org/10.1016/j.eurpsy.2006.04.009.

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AbstractThis prospective, longitudinal study compared the frequency and pattern of mood changes between outpatients receiving usual care for bipolar disorder who were either taking or not taking antidepressants. One hundred and eighty-two patients with bipolar disorder self-reported mood and psychiatric medications for 4 months using a computerized system (ChronoRecord) and returned 22,626 days of data. One hundred and four patients took antidepressants, 78 did not. Of the antidepressants taken, 95% were selective serotonin or norepinephrine reuptake inhibitors, or second-generation antidepressants. Of the patients taking an antidepressant, 91.3% were concurrently taking a mood stabilizer. The use of antidepressants did not influence the daily rate of switching from depression to mania or the rate of rapid cycling, independent of diagnosis of bipolar I or II. The primary difference in mood pattern was the time spent normal or depressed. Patients taking antidepressants frequently remained in a subsyndromal depression. In this naturalistic study using self-reported data, patients with bipolar disorder who were taking antidepressants—overwhelmingly not tricyclics and with a concurrent mood stabilizer—did not experience an increase in the rate of switches to mania or rapid cycling compared to those not taking antidepressants. Antidepressants had little impact on the mood patterns of bipolar patients taking mood stabilizers.

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20

Keck, Paul E., Mark A. Frye, and Michael E. Thase. "Bipolar Depression: Best Practices for the Hospitalized Patient." CNS Spectrums 12, S19 (November 2007): 4–11. http://dx.doi.org/10.1017/s1092852900015844.

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One of the most challenging clinical topics in psychiatry is the diagnosis and treatment of bipolar depression. The term mood stabilizer is frequently employed in the treatment of the hospitalized bipolar patient, although clinicians do not universally agree on a consensus definition of this term. Most clinicians would agree that a mood stabilizer refers to a medication that is effective for the acute treatment of manic, mixed, hypomanic, or depressive episodes. Many experts agree that such treatment should offer efficacy against mania, should not worsen depression, and preferably should treat depression as well. In addition, the acute effectiveness in stabilization should not be at the expense of inducing alternate mood symptoms or switching the patient into the alternate phase of illness. From a maintenance standpoint, a mood stabilizer should also prevent against future relapse or recurrence of manic, mixed, hypomanic, or depressive symptoms or episodes (Slide 1).In addition to use of mood stabilizers, there are other issues surrounding treatment of the hospitalized patient with bipolar depression, including the commonly comorbid issue of substance abuse. Hazardous drinking may more commonly occur in bipolar depression or depressive phase of illness, representing a more complex clinical picture. To facilitate understanding of this complex disorder and its appropriate treatment, this discussion centers around the case of a major depressive episode in a patient with a past history of of mania (ie, bipolar I depression or bipolar depression).

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21

Citrome, Leslie. "Use of Lithium, Carbamazepine, and Valproic Acid in a State-Operated Psychiatric Hospital." Journal of Pharmacy Technology 11, no. 2 (March 1995): 55–59. http://dx.doi.org/10.1177/875512259501100210.

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Objective: To examine the prescribing of mood stabilizers (lithium, carbamazepine, and valproic acid) in a 500-bed state-operated psychiatric hospital in New York. Method: All 129 inpatients receiving mood stabilizers were identified and their medical records reviewed using a standardized drug use evaluation form. Diagnosis, other indications, and prior experience with mood stabilizers were examined, as well as outcome and adverse effects. Results: Approximately one-quarter of the inpatient population received a mood stabilizer. The frequency of carbamazepine use exceeded the use of lithium, with 72 patients receiving carbamazepine and only 62 receiving lithium. Twenty-eight patients received valproic acid. Indications found most frequently for carbamazepine use included assaultive or aggressive behavior (70% for those receiving carbamazepine as the only mood stabilizer). Of those patients with bipolar or schizoaffective disorder and receiving either lithium, carbamazepine, or valproic acid, 36% were prescribed carbamazepine (10% as a first-line agent) and 50% lithium (26% as a first-line agent). None of these indications for carbamazepine has been approved by the Food and Drug Administration. In general, positive outcomes were documented but without supporting objective measures. Significant adverse effects were documented in the medical record in one-quarter of the patients. Conclusions: There was widespread use of the three mood stabilizers examined, singly and in combination, for a variety of indications. Lithium and valproic acid remain more frequently prescribed for the treatment of bipolar and schizoaffective disorders. Monotherapy with carbamazepine or valproic acid results in statistically significantly fewer adverse effects than lithium or combination therapy (p values between p = 0.00038 and p = 0.006). Current clinical practice has endorsed the use of carbamazepine for aggressive or assaultive behavior, although there does not appear to be sufficient proof of effectiveness in the literature. Formal studies of carbamazepine's antiagressive effects should be conducted.

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22

Grunze, H. C. R., J. Langosch, C. Normann, D. Rujescu, B. Amann, and J. Waiden. "Dysregulation of ion fluxes in bipolar affective disorder." Acta Neuropsychiatrica 12, no. 3 (September 2000): 81–85. http://dx.doi.org/10.1017/s0924270800035468.

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ABSTRACTBipolar disorder has attracted numerous research from different neurobiological angles. This review will summarize selected findings focusing on the role of disturbed transmem-braneous ion fluxes. Several mood stabilizers exhibit a distinct profile including effects on sodium, calcium and potassium conductance. In summary, some decisive mechanisms of action as calcium antagonism and modulation of potassium currents may play a crucial role in the success of any given mood stabilizer in bipolar disorder.

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23

Tournier, M., A. Cougnard, B. Bégaud, A. Thiébaut, and H. Verdoux. "The Metabolic Impact of the Antipsychotic Drugs in Patients with Bipolar Disorder." European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)70490-0.

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Objective:To assess the metabolic impact of adding an antipsychotic to a mood stabilizer or switching a mood stabilizer to an antipsychotic in patients with bipolar disorder.Methods:A retrospective fixed cohort study was conducted through the claims database of the French health care program for the self-employed workers. The study population consisted of 3.172 patients age 18 and over who were exposed to mood stabilizers (i.e. lithium, valproate) a 3 month-period in 2004 without dispensing of non-sedative antipsychotic, antidiabetic or lipid-lowering drugs. The outcome was the occurrence of a metabolic incident over the follow-up period, using the dispensing of an antidiabetic drug as a marker of diabetes and the dispensing of a lipid-lowering drug as a marker of hypercholesterolemia or hypertriglyceridemia. A Cox proportional hazard model was used to assess the metabolic impact of the antipsychotics; using mood stabilizers as a reference. Antipsychotic exposition was stratified in «current» and «recent» (discontinued for less than 6 months) at the time of the metabolic incident.Results:196 patients (6.2%) received a first-generation antipsychotic, 352 (11.1%) a second-generation antipsychotic, 565 (17.8%) a sedative antipsychotic and 367 patients (11.6%) presented with a metabolic incident over the study period. The recent dispensing of a second-generation antipsychotic was associated with the occurrence of a metabolic incident [HR 2.1 (95%CI 1.2-3.7) p=0.006], while current dispensing or dispensing of first-generation antipsychotics were not.Conclusion:Second-generation antipsychotics have a metabolic impact compared to classic mood stabilizers in patients with bipolar disorder.

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24

Sajatovic, Martha, Debra W. Brescan, Dalia E. Perez, Sue K. DiGiovanni, Helen Hattab, Joan Belton Ray, and C. Raymond Bingham. "Quetiapine Alone and Added to a Mood Stabilizer for Serious Mood Disorders." Journal of Clinical Psychiatry 62, no. 9 (September 15, 2001): 728–32. http://dx.doi.org/10.4088/jcp.v62n0911.

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25

Gelenberg, Alan, and Ronald Pies. "Matching the Bipolar Patient and the Mood Stabilizer." Annals of Clinical Psychiatry 15, no. 3 (September 1, 2003): 203–16. http://dx.doi.org/10.3109/10401230309085690.

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26

Altamura, A. C., D. Madaro, D. Salvadori, and F. Sassella. "Quetiapine as a mood stabilizer in bipolar disorder." European Neuropsychopharmacology 11 (January 2001): S238—S239. http://dx.doi.org/10.1016/s0924-977x(01)80258-3.

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27

Yan, Jun. "Restraint Urged in Adding Antidepressant to Mood Stabilizer." Psychiatric News 43, no. 11 (June 6, 2008): 34. http://dx.doi.org/10.1176/pn.43.11.0034.

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28

Keck Jr, P. E., S. L. McElroy, N. Richtand, and M. Tohen. "What makes a drug a primary mood stabilizer?" Molecular Psychiatry 7, S1 (January 2002): S8—S14. http://dx.doi.org/10.1038/sj.mp.4001013.

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29

Quartini, Adele, Angela Iannitelli, and Giuseppe Bersani. "Lithium: from mood stabilizer to putative cognitive enhancer." Neural Regeneration Research 11, no. 8 (2016): 1234. http://dx.doi.org/10.4103/1673-5374.189175.

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30

Shastry, Barkur S. "On the functions of lithium: The mood stabilizer." BioEssays 19, no. 3 (March 1997): 199–200. http://dx.doi.org/10.1002/bies.950190304.

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31

Gelenberg, Alan J., and Ronald Pies. "Matching the Bipolar Patient and the Mood Stabilizer." Annals of Clinical Psychiatry 15, no. 3/4 (September 2003): 203–16. http://dx.doi.org/10.1023/b:acli.0000008174.46414.a4.

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32

Hochman, E., A. Krivoy, A. Weizman, and A. Valevski. "One-year rehospitalization rates in bipolar disorder manic patients discharged on mood stabilizers versus mood stabilizer combined with antipsychotics." European Neuropsychopharmacology 26 (October 2016): S423. http://dx.doi.org/10.1016/s0924-977x(16)31394-3.

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33

Vieta, E., C. Bowden, K. Ice, O. Gurtovaya, J. Schwartz, and P. Wang. "A 6-month, Randomized, Placebo-controlled, Double Blind Trial of Ziprasidone Plus a Mood Stabilizer in Subjects With Bipolar I Disorder." European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)70827-2.

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Background:The objective of this study was to evaluate the efficacy and safety of ziprasidone adjunctive to a mood stabilizer for the maintenance treatment of bipolar mania.Methods:Male and female subjects with bipolar I disorder with MRS 3 14 were enrolled. Subjects achieving ≥ 8 consecutive weeks of stability with open-label ziprasidone (80-160 mg/d) and lithium or divalproex were randomized into the 6-month double-blind maintenance period, to ziprasidone + mood stabilizer or placebo + mood stabilizer. The primary and key secondary end points were the time to intervention for a mood episode, and time to discontinuation for any reason, respectively. Inferential analysis was performed using a Kaplan-Meier product-limit estimator (Log-rank test).Results:127 and 112 subjects were randomized to and treated in the ziprasidone and placebo groups, respectively. The time to intervention for a mood episode was significantly different, favoring ziprasidone (p = 0.0104). 19.7% and 32.4% of ziprasidone and placebo subjects, respectively, required intervention for a mood episode. Time to discontinuation for any reason was significantly different (p = 0.0047), favoring ziprasidone. Among treatment-emergent adverse events occurring in the double-blind period, the only event occurring more frequently in the ziprasidone group than in the placebo group (≥ 5%) was tremor (6.3% vs 3.6%, respectively).Conclusions:These results demonstrate that ziprasidone is an effective, safe, and well-tolerated adjunctive treatment with a mood stabilizer for long-term maintenance treatment of bipolar mania.

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34

Kahn, David, and Rebecca Chaplan. "The “Good Enough” Mood Stabilizer: A Review of the Clinical Evidence." CNS Spectrums 7, no. 3 (March 2002): 227–37. http://dx.doi.org/10.1017/s1092852900017594.

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ABSTRACTA growing family of medications is used for mood stabilization in bipolar disorder. These medications fall into two broad categories according to likely mechanisms of action. Within the categories, specific drugs may vary in their efficacy for different phases of the disorder. The first category, including lithium, anticonvulsants, and some novel treatments, appears to have mechanisms related to intracellular second messengers. These medications have more pronounced antimanic than antidepressant effects, except for lamotrigine, which has antidepressant effects without precipitating mania. The second group of mood stabilizers is the atypical antipsychotics, which act through dopamine and other monoamines. Olanzapine and in all likelihood other drugs in the class possess marked, acute antimanic properties and possible antidepressant properties, but require further study before they can be used as routine options in long-term care. It is clear that the advent of multiple mood stabilizer candidates has not yet led to a single ideal therapy for bipolar disorder, but rather to options that can be flexibly tailored to the lifetime needs of individual patients, in sequences or combinations, and perhaps in conjunction with other classes of psychotropics.

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35

Hahn, Chang-Gyu, Laszlo Gyulai, Claudia F. Baldassano, and Robert H. Lenox. "The Current Understanding of Lamotrigine as a Mood Stabilizer." Journal of Clinical Psychiatry 65, no. 6 (June 15, 2004): 791–804. http://dx.doi.org/10.4088/jcp.v65n0610.

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36

Leckband, Susan G., Michael McCarthy, and John R. Kelsoe. "The pharmacogenomics of mood stabilizer response in bipolar disorder." Mental Health Clinician 1, no. 9 (March 1, 2012): 217–21. http://dx.doi.org/10.9740/mhc.n99509.

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Bipolar Disorder (BD) is a common psychiatric illness that has a recurring course and 17% - 24% lifetime prevalence of suicide attempts. Difficulty in diagnosis and individual variation in response point to a great need for personalized medicine. Studies to date have focused largely on lithium and suggest the idea that different medication responses may reflect different disease mechanisms. An overview of current pharmacogenomic studies will be presented and needs and future directions discussed.

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37

Ballenger, J. C. "The Current Understanding of Lamotrigine as a Mood Stabilizer." Yearbook of Psychiatry and Applied Mental Health 2006 (January 2006): 216–17. http://dx.doi.org/10.1016/s0084-3970(08)70211-1.

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38

Bauer, Mark S., and Landis Mitchner. "What Is a “Mood Stabilizer”? An Evidence-Based Response." American Journal of Psychiatry 161, no. 1 (January 2004): 3–18. http://dx.doi.org/10.1176/appi.ajp.161.1.3.

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39

SUNDARARAJAN, VIDYA, and ASHOK K. JAINER. "A Mood Stabilizer With Risperidone or Haloperidol for Mania." American Journal of Psychiatry 161, no. 11 (November 2004): 2139–40. http://dx.doi.org/10.1176/appi.ajp.161.11.2139.

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40

ANDRADE, CHITTARANJAN. "A Mood Stabilizer With Risperidone or Haloperidol for Mania." American Journal of Psychiatry 161, no. 11 (November 2004): 2140. http://dx.doi.org/10.1176/appi.ajp.161.11.2140.

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41

MAZER-POLINE, CARRIE, ARTHUR RIFKIN, STEPHEN GEISLER, and TINA WALCH. "Mood Stabilizer Discontinuation in Pregnant Women With Bipolar Disorder." American Journal of Psychiatry 165, no. 5 (May 2008): 646–47. http://dx.doi.org/10.1176/appi.ajp.2008.08010036.

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42

Freeman, Marlene P., and Andrew L. Stoll. "Mood Stabilizer Combinations: A Review of Safety and Efficacy." American Journal of Psychiatry 155, no. 1 (January 1998): 12–21. http://dx.doi.org/10.1176/ajp.155.1.12.

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43

Shaltiel, Galit, Emma C. Dalton, Robert H. Belmaker, Adrian J. Harwood, and Galila Agam. "Specificity of mood stabilizer action on neuronal growth cones." Bipolar Disorders 9, no. 3 (May 2007): 281–89. http://dx.doi.org/10.1111/j.1399-5618.2007.00400.x.

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44

Soares, J. C. "Can brain-imaging studies provide a ‘mood stabilizer signature?’." Molecular Psychiatry 7, S1 (January 2002): S64—S70. http://dx.doi.org/10.1038/sj.mp.4001020.

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45

CHANG, KIKI D., and TERENCE A. KETTER. "Mood Stabilizer Augmentation with Olanzapine in Acutely Manic Children." Journal of Child and Adolescent Psychopharmacology 10, no. 1 (January 2000): 45–49. http://dx.doi.org/10.1089/cap.2000.10.45.

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46

Dan, I. A., G. Marian, and A. Varghes. "Bipolar disorder-mixed episode: adding mood stabilizer to antipsychotics." European Psychiatry 22 (March 2007): S251. http://dx.doi.org/10.1016/j.eurpsy.2007.01.840.

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47

Karanti, Alina, Mathias Kardell, Ulrika Lundberg, and Mikael Landén. "Changes in mood stabilizer prescription patterns in bipolar disorder." Journal of Affective Disorders 195 (May 2016): 50–56. http://dx.doi.org/10.1016/j.jad.2016.01.043.

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48

Patel, Nick C., M. Lynn Crismon, and Michael Pondrom. "Rehospitalization Rates of Patients With Bipolar Disorder Discharged on a Mood Stabilizer Versus a Mood Stabilizer Plus an Atypical or Typical Antipsychotic." Journal of Behavioral Health Services & Research 32, no. 4 (October 2005): 438???445. http://dx.doi.org/10.1097/00075484-200510000-00009.

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49

Patel, Nick C., M. Lynn Crismon, and Michael Pondrom. "Rehospitalization rates of patients with bipolar disorder discharged on a mood stabilizer versus a mood stabilizer plus an atypical or typical antipsychotic." Journal of Behavioral Health Services & Research 32, no. 4 (October 2005): 438–45. http://dx.doi.org/10.1007/bf02384203.

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50

Ware, Kenric, Erika Tillery, and Lauren Linder. "General pharmacokinetic/pharmacodynamic concepts of mood stabilizers in the treatment of bipolar disorder." Mental Health Clinician 6, no. 1 (January 1, 2016): 54–61. http://dx.doi.org/10.9740/mhc.2016.01.054.

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Abstract Introduction Mood stabilizers are the recommended treatment for patients who receive a diagnosis of bipolar disorder. Because of the necessity of mood stabilizer treatment in patients with bipolar disorder and the extent of pharmacokinetic and pharmacodynamic principles involved, the purpose of this review is to summarize the pharmacokinetic principles of lithium in addition to the pharmacodynamics of lithium, carbamazepine, lamotrigine, and valproic acid/valproate. Methods Practice guidelines, review articles, and clinical trials were located using online databases PubMed, CINAHL, IDIS, and Medline. Search terms included at least one of the following: bipolar disorder, carbamazepine, lamotrigine, lithium, mood stabilizers, pharmacokinetics, pharmacodynamics, valproate, and valproic acid. Online clinical databases Dynamed® and Lexicomp® were also used in the study. Results Mood stabilizers collectively possess distinct qualities that are closely regarded before, during, and after therapeutic initiation. Individual patient characteristics, coupled with these observed traits, add to the complexity of selecting the most optimal neurologic agent. Each medication discussed uniquely contributes to both the maintenance and restoration of overall patient well-being. Discussion Introduction of mood stabilizers into drug regimens is often done in the presence of an array of mitigating factors. Safety and efficacy measures are commonly used to gauge desired results. Careful monitoring of patients' responses to selected therapies is paramount for arriving at appropriate clinical outcomes.

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