Finding the right medication (and the right dosage level) for someone who has depression can often be a trial-and-error process. Unfortunately, for some people, no antidepressant seems to help. Do these individuals have other medication options? For example, do mood stabilizers help with depression?
Learn more on our 2024 Guide to Mental Health Medications
What Are Mood Stabilizers?
Mood stabilizers are a category of medications that are often prescribed to treat people who have bipolar disorder. Four of the most common mood stabilizers are lithium, valproic acid, carbamazepine, and lamotrigine. Here’s a quick look at the features and potential drawbacks of each of these medications:
The first mentions of lithium in medical literature are from the mid-1800s. However, by the end of that century, the use of this medication seems to have fallen out of favor. It wasn’t until the 1950s when researchers once again began to assess lithium’s mental health benefits. The medication was approved by the U.S. Food and Drug Administration (FDA) in 1970.
Lithium’s side effects include nausea, vomiting, hand tremors, lethargy, kidney damage, confusion, and weight gain. However, many professionals believe that the risks associated with this medication have been overstated. A May 2020 article in the journal Frontiers in Psychiatry described lithium as “the gold standard” for long-term treatment of bipolar disorder.
As with lithium, the history of valproic acid as a mental health medication dates to the 1800s. In the 1960s, researchers discovered that it also had anticonvulsant properties. The FDA has approved valproic acid to treat people who have been experiencing seizures, though it is also commonly used on an off-label basis to help people who have bipolar disorder (primarily to ease manic symptoms).
Like lithium, valproic acid can also cause nausea, diarrhea, tremors, and weight gain. However, research indicates that these effects usually subside after a person has been taking the medication for a while, or after their dosage has been adjusted.
Similar to valproic acid, carbamazepine is also an anticonvulsant. It is also used to treat people who have been experiencing neuralgia (nerve pain) and bipolar disorder. Among patients who have bipolar disorder, carbamazepine is often prescribed to those who have manic or mixed episodes.
Carbamazepine has been approved for use in the U.S. since the late 1960s. Possible side effects of carbamazepine include dizziness, weight gain, headaches, and nausea.
Lamotrigine joins carbamazepine and valproic acid as anticonvulsants that are also used as mood stabilizers for people who have bipolar disorder. It is the newest medication on this list, having been patented in 1980 and approved by the FDA in the mid-1990s.
The most prevalent side effects of lamotrigine are fatigue, fever, and rash. The rash can be especially serious, to the point that the FDA has mandated a black box warning to advise patients of this possible effect. It can also cause headaches, insomnia, constipation, and weight gain.
Do Mood Stabilizers Help with Depression?
Now that we’ve discussed the mood stabilizers that are usually used to treat bipolar disorder, let’s address the question at the top of this post: Do mood stabilizers help with depression?
While they are rarely used as a first-line medication for depressive disorders, mood stabilizers have been able to help people whose symptoms were not alleviated by more traditional antidepressants. Today, people who are diagnosed with a depressive disorder are usually prescribed one of the following types of medications.
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin and noradrenaline reuptake inhibitors (SNRIs)
- Noradrenaline and specific serotonergic antidepressants (NASSAs)
If, after taking one or more of the medications listed above, a person doesn’t show improvement, their treatment provider may prescribe a mood stabilizer.
One of the mood stabilizers from the previous section, carbamazepine, is also classified as a tricyclic antidepressant. Prior to the development of SSRIs in the 1980s, tricyclics and monoamine oxidase inhibitors (MAOIs) were much more frequently used to treat depression. However, primarily due to the intensity of their side effects, these medications are now used only after patients have had unsuccessful experiences with SSRIs, SNRIs and NASSAs.
As for the other three mood stabilizers that we previously discussed:
- Lithium is typically used as an add-on medication in depression treatment. This means that it is prescribed to people who are already taking an SSRI or another medication.
- Valproic acid has proved to be an effective medication for easing depressive episodes among people who have bipolar disorder. Studies suggest that it can also provide long-term benefits to people who have treatment-resistant depression.
- According to a March 2022 article in the journal Neuropsychopharmacology Reports, lamotrigine may be an effective second-line intervention for people who have persistent depressive disorder, but who have not improved after being treated with SSRIs or other first-line antidepressants.
As indicated by the many medication options that we’ve identified in this post, treatment for depression is by no means a one-size-fits-all endeavor. Medications and therapies that are ideal for one person may have little to no positive effect on someone else.
This underscores the importance of finding a treatment provider who will work closely with you to determine the full scope of your needs, identify your immediate and long-term goals, and develop a comprehensive, customized plan just for you. Once you’ve begun to receive depression treatment, your provider should monitor your progress and make necessary adjustments when appropriate.
Begin Depression Treatment in Atlanta
If you have been struggling with the symptoms of a depressive disorder or another mental health concern, the Atlanta Integrative Psychiatry team is here for you. Our our outpatient depression treatment center is a safe and welcoming place where you can receive evidence-based services from a team of highly skilled professionals.
We understand that each person who develops a mental health disorder is impacted in a unique manner, and we are committed to providing you with a truly personalized treatment experience. Working together, we can help you find your path toward a healthier and much more hopeful future. To learn more about our programming, or to schedule a free assessment, please visit our appointment page or call our center today.