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NeuroPsychopharmacotherapy pp 1–21Cite as

Mood Stabilizers: Side Effects, Contraindications, and Interactions

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Abstract

The key mood stabilizers used in clinical practice are a heterogeneous group of medications with multiple disparities. Included among this group are lithium, certain antiepileptic drugs such as carbamazepine, lamotrigine, and valproate, as well as certain atypical antipsychotics such as asenapine, olanzapine, quetiapine, and risperidone. The side effect profile is varied, but these medications can have an impact on the central nervous system as well as the cardiac, gastrointestinal, endocrine, renal, and the hematopoietic systems. Sexual and allergic side effects are also of significant importance. Among the mood stabilizers, valproate treatment seemingly carries the highest risk for birth defects. Other specific side effects of clinical importance include lithium toxicity which can lead to ataxia, rigor, cerebral seizures, and shock; decreased bone marrow function under carbamazepine treatment; and Stevens-Johnson syndrome and Lyell’s syndrome induced by carbamazepine or lamotrigine. In addition to this, it is important to be aware of the risk of liver failure and pancreatic damage caused by valproate and weight gain and metabolic disturbances associated with atypical antipsychotics such as olanzapine and quetiapine.

Having a pre-existing condition which affects any of the organs listed above puts the patient at higher risk of developing these side effects. Hence, this would be one of the major contraindications. Conditions involving the organs which metabolize the medication in question can also present as a contraindication, for example, if the condition involves the liver or kidneys.

In order to gauge potential interactions, one must take into account the metabolization and elimination of the medication, together with the medication’s potential to induce or inhibit cytochrome P450 isoenzymes and glucuronosyltransferases.

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Authors and Affiliations

  1. Department of Psychological Medicine, King’s College London, London, UK

    Hubertus Himmerich

  2. Bethlem Royal Hospital, South London and Maudsley NHS Foundation Trust, London, UK

    Amy Hamilton

Authors
  1. Hubertus Himmerich
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  2. Amy Hamilton
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Corresponding author

Correspondence to Hubertus Himmerich .

Editor information

Editors and Affiliations

  1. Dept Psychiatry , Psychosomatics & Psychotherapy, University of Würzburg, Medical School Clinical Neurochemistry, Würzburg, Germany

    Peter Riederer

  2. Inst für Psychologische Medizin, Haag, Bayern, Germany

    Gerd Laux

  3. Department of Psychiatry, University of Toronto Department of Psychiatry, Toronto, ON, Canada

    Benoit Mulsant

  4. Center Translational Res Neurol Diseases, Dalian Med Uni Shanghai Inst Health Sc Center Translational Res Neurol Diseases, Dalian, China

    Weidong Le

  5. Fujita Health University School Medicine, Toyoake, Aichi, Japan

    Toshiharu Nagatsu

Section Editor information

  1. Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany

    Andreas Menke

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Himmerich, H., Hamilton, A. (2020). Mood Stabilizers: Side Effects, Contraindications, and Interactions. In: Riederer, P., Laux, G., Mulsant, B., Le, W., Nagatsu, T. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-319-56015-1_40-1

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  • DOI: https://doi.org/10.1007/978-3-319-56015-1_40-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-56015-1

  • Online ISBN: 978-3-319-56015-1

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