Mood stabilisers

What are mood stabilisers? 

Mood stabilisers, including lithium and anticonvulsants have been proposed as an adjunctive therapy to standard antipsychotic treatments when individuals have sub-optimal responses to treatment. Mood stabilisers may be implemented as an immediate therapy for acute symptoms of psychosis, but they may also be used as part of an ongoing treatment regime. Mood stabiliser medications assessed in this topic include lithium as well as anticonvulsant medications (valproate, carbamazepine, and lamotrigine).

What is the evidence for mood stabilisers?

Moderate to high quality evidence suggests a small effect of adjunctive lithium for improvements in overall symptoms. Moderate quality evidence suggests a small effect of improvements in global state, reflected by clinical response. There is a medium-sized effect of adjunctive lithium for increasing the risk of people leaving a study early. Low quality evidence is unclear as to any benefit of lithium for improving symptoms of tardive dyskinesia.

Moderate quality evidence suggests no benefit of adjunctive lamotrigine for symptoms, however some benefit may be seen in antipsychotic-resistant patients who are receiving clozapine.

Moderate quality evidence suggests no benefit of adjunctive valproate compared to placebo for study attrition or mental state, however, valproate may lower the risk of constipation and tardive dyskinesia, and increase the risk of sedation. Lower quality evidence suggests no benefit of valproate for reducing aggressive behaviour.

Moderate to low quality evidence suggests a medium-sized effect of improvements in global state with adjunctive carbamazepine.

March 2019

Last updated at: 11:58 pm, 20th March 2019
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Title Colour Legend:
Green - Topic summary is available.
Orange - Topic summary is being compiled.
Red - Topic summary has no current systematic review available.