Mood Stabilizers

There are several different types of mood stabilizers.
They act differently and have different side effects.

These drugs include:
• Carbamazepine (Carbatrol, Epitol, Equetro, Tegretol)
• Divalproex sodium (Depakote)
• Lamotrigine (Lamictal)
• Lithium
• Valproic acid (Depakene)

Side Effect Studies by Mood Stabilizer category below:

Increased Suicidal Thoughts FDA warnings on Aniti-Epileptic mood stabilizers:
https://www.psychiatrictimes.com/view/fda-dictates-suicide-ideation-warning-antiepileptics-used-bipolar-disorder
Some of the 11 antiepileptics of concern to the FDA are also used to treat bipolar disorder. These include divalproex (Depakote), lamotrigine (Lamictal), and carbamazepine (Teg­retol).
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Carbamazepine (Carbatrol, Epitol, Equetro, Tegretol) Side Effects

Potential for Severe Skin Rash
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3546217/

Stevens-Johnson syndrome (SJS) is a rare but life-threatening skin reaction disease and carbamazepine is one of its most common causes
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Carbamazepine–the Commonest Cause of Toxic Epidermal Necrolysis and Stevens-Johnson Syndrome: A Study of 7 Years

https://pubmed.ncbi.nlm.nih.gov/16394456/

Toxic epidermal necrolysis [ Toxic epidermal necrolysis (TEN), also known as Lyell’s syndrome, is a widespread life-threatening mucocutaneous disease where there is extensive detachment of the skin and mucous membrane]  and Stevens-Johnson syndrome are a group of severe life threatening drug reactions

Divalproex sodium (Depakote)

Birth Defect
Birth Injury Guide
Depakote Causes Many Birth Defects including
Cleft Lip or Palate, Heart Defects, Spina Bifida and many more.
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Liver Damage

Valproate or valproic acid (Depakote) … is a well known cause of several distinctive forms of acute and chronic liver injury.
https://www.ncbi.nlm.nih.gov/books/NBK548284/

Lamotrigine (Lamictal)

FDA warns of serious immune system reaction with seizure and mental health medicine lamotrigine (Lamictal) Safety
https://www.fda.gov/media/112401/download
Announcement [04-25-2018] The Food and Drug Administration (FDA) is warning that the medicine lamotrigine (Lamictal) for seizures and bipolar disorder can cause a rare but very serious reaction that excessively activates the body’s infection-fighting immune system. This can cause severe inflammation throughout the body and lead to hospitalization and death.
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Lamotrigine (book)

https://www.ncbi.nlm.nih.gov/books/NBK470442/
last updated  April 13, 2020
United States Boxed Warning: Lamotrigine can cause serious rashes requiring hospitalization and discontinuation of this medication. Rash severity varies but includes a risk for Stevens-Johnson syndromeOther adverse effects include multi-organ sensitivity, blood dyscrasias, suicidal behavior/ideations, aseptic meningitis, status epilepticus, and sudden unexplained death in epilepsy.

Lithium

54% of people prescribed Lithium stop taking the drug, 62% of them due to the side effects.

Feb 2018 BMC Psychiatry
Review of medical records for all episodes of lithium discontinuation that had occurred between 1997 and 2013 with the intent to stop lithium for good.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5804058/
Results: Of 873 patients treated with lithium, 54% discontinued lithium, corresponding to 561 episodes of lithium discontinuation. In 62% of episodes, lithium was discontinued due to adverse effects, in 44% due to psychiatric reasons, and in 12% due to physical reasons interfering with lithium treatment

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Lithium side effects and toxicity: prevalence…

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5164879/#:~:text=Because%20of%20this%2C%20avoidance%20of,2016).

Tremor, primarily of the hands, is among the most common lithium side effects, seen in approximately one quarter of treated patients (Gelenberg and Jefferson )

Nausea, seen in 10–20% of lithium-treated patients.  (Schou et al. 1970).

Diarrhea in up to 10% of lithium-treated patients (Vestergaard et al. ).

Excessive urination and thirst with rates up to 70% in long-term patients (Bone et al. ; Vestergaard et al. ; Gitlin et al. ).

37% of bipolar patients on lithium had sexual dysfunction (Grover et al. ).

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Lithium is associated with an increased risk of renal failure, particularly among the older age group. [Destroyed kidneys]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3966731/
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Lithium Poisoning Occurs Frequently
https://emedicine.medscape.com/article/815523-overview

 

Valproic acid (Depakene) 

FDA WARNING on several side effects
https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/018081s056lbl.pdf
WARNINGS: LIFE THREATENING ADVERSE REACTIONS …Hepatotoxicity, including fatalities, usually during first 6 months of treatment. Children under the age of two years and patients with mitochondrial disorders are at higher risk. Monitor patients closely, and perform serum liver testing prior to therapy and at frequent intervals thereafter (5.1) • Fetal Risk, particularly neural tube defects, other major malformations, and decreased IQ (5.2, 5.3, 5.4) • Pancreatitis, including fatal hemorrhagic cases (5.5)


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