For adults with PTSD who do not respond to antidepressants, doctors may prescribe a mood stabilizer. Mood stabilizers work by balancing brain chemicals that regulate emotions. Doctors often prescribe these to people with PTSD when the main symptoms are anger, agitation, or irritability. In this article, we shall discuss how mood stabilizers can help treat Post-Traumatic Stress Disorder (PTSD).
Post-traumatic stress disorder (PTSD) can develop after any trauma — from military service to a natural disaster.
Mood stabilizers are one of many treatment options for PTSD. They’re more commonly used to treat mood disorders, but they can also help manage symptoms of PTSD.
Mood stabilizers aren’t typically a first-line treatment for PTSD because they can cause severe side effects and lead to other medical problems such as kidney and liver function issues.
But in some cases, mood stabilizers could be used in conjunction with therapy or other medications to help you better manage your moods and emotions.
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What are mood stabilizers?
Mood stabilizers are categorized as psychiatric medications.
They’re often used to treat bipolar disorder. While they’re not a cure for this condition, they can help balance your moods throughout the day and reduce your chance of experiencing extreme shifts in moods such as depression or manic episodes.
Some mood stabilizers could also be used to reduce convulsions caused by epilepsy or other seizure disorders. They can also treat other conditions such as borderline personality disorder and migraine.
These medications can be prescribed alone or along with other mood-stabilizing drugs or antidepressants.
Medications that can be considered mood stabilizers include:
Lithium or lithium carbonate is the only medication that falls into this category. It has a long history of safe use, with approval from the Food and Drug Administration (FDA) dating to 1970.
The kidneys process and eliminate lithium from the body. You’ll likely need regular blood tests to monitor your kidney function if you take lithium.
In prescription form, lithium may be under brand names such as:
Antipsychotics might be prescribed for use alone or with other mood stabilizers.
Common antipsychotics used as mood stabilizers include:
- aripiprazole (Abilify)
- asenapine (Saphris)
- lurasidone (Latuda)
- olanzapine (Zyprexa)
- quetiapine (Seroquel)
- risperidone (Risperdal)
- ziprasidone (Geodon)
Anticonvulsants are primarily used to treat epilepsy and similar seizure conditions. However, they’re also effective in treating mood disorders and PTSD under certain circumstances.
Common anticonvulsants used as mood stabilizers include:
- carbamazepine (Carbatrol, Tegretol)
- lamotrigine (Lamictal)
- valproic acid, aka valproate or divalproex sodium (Depakote, Depakene)
There are a few anticonvulsants that are used “off-label,” — meaning that the medication wasn’t approved or intended for use as a mood stabilizer but might be prescribed for that purpose.
- gabapentin (Neurontin)
- oxcarbazepine (Trileptal)
- topiramate (Topamax)
How do they help with PTSD?
Mood stabilizers help regulate and balance emotions.
These medications might help regulate brain chemistry by preventing over- or under-stimulation of different areas of the brain. Nevertheless, research is ongoing to fully understand what these medications do and how they affect the human body.
Mood stabilizers aren’t considered a first-line treatment for PTSD. They’re typically used along with other PTSD treatments, such as therapy and other medications.
Mood stabilizers might be considered when other treatment options haven’t worked or aren’t well tolerated.
In particular, they could help if you’re experiencing aggression, anger, or high levels of irritability. They might also be used if you have a coexisting mood disorder such as borderline personality disorder or bipolar disorder.
Mood stabilizers come with side effects like many other medications.
Common side effects of mood stabilizers include:
- abdominal pain
- light sensitivity
- rapid heartbeat
- unusual bruising or bleeding
- weight gain
One of the reasons mood stabilizers aren’t a first-line treatment for PTSD is the possibility of severe side effects.
These could include:
- suicidal ideation
- pancreatitis (inflammation of the pancreas)
- low sodium levels
- aseptic meningitis (inflammation of the brain and spinal cord membrane)
- liver and kidney problems
- Steven Johnson’s syndrome (primarily seen with lamotrigine)
Severe side effects could be an emergency and require immediate medical attention.
Mood stabilizers can help manage your symptoms, but there are a few things to be aware of.
- Interactions with other medications. Some medications might interact with mood stabilizers and could lead to potentially harmful side effects. Before this medication is prescribed, a healthcare or mental health professional will ask about your medical history and your past and current medications to prevent this.
- Close monitoring. You will likely have regular blood tests to keep an eye on your medication levels and your liver and kidney function.
- Pregnancy. If you’re pregnant, you might be monitored closely for side effects. Consider talking with your doctor if you’re pregnant or plan to become pregnant.
- Overdose. This is a medical emergency that will require immediate attention from healthcare professionals and poison control.
- Withdrawal. Abruptly stopping a medication without consulting a medical professional could lead to symptoms of withdrawal. If you want to stop taking a mood stabilizer or any other medication, a doctor can offer guidance. Medical professionals recommend gradually reducing (aka tapering) the dose before you stop completely to prevent serious side effects.
- Children and teens. Most of the information about mood stabilizers comes from studies on adults. There’s little research about how mood stabilizers affect children and teens. For that reason, they’re rarely prescribed for these age groups.
Some mood stabilizers — such as lithium and valproate — come with black box warnings about potential severe or life-threatening side effects.
Each medication can have a black box warning. For example:
- High doses of lithium in the blood can be poisonous, a condition known as lithium toxicity.
- Valproate can cause liver damage, inflammation in the pancreas, and birth defects.
- Carbamazepine can lower white blood cells and increase your chance of infection.
Other medications used for PTSD
Medications used to treat depression and anxiety are often used to help manage symptoms of PTSD.
Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), might be used to help reduce symptoms of depression or anxiety in people with PTSD.
The common SSRIs prescribed include:
- fluoxetine (Prozac)
- paroxetine (Paxil)
- sertraline (Zoloft)
Other antidepressants that might be used include:
- selective norepinephrine reuptake inhibitors (SNRIs)
- monoamine oxidase inhibitors (MAOIs)
Each of these antidepressants works differently. A healthcare or mental health professional can help determine the best treatment for you.
In summary, living with PTSD can be challenging. But there are plenty of options to help you manage your symptoms.
Mood stabilizers are an effective option when other PTSD treatments haven’t worked as well or when you have other disorders that affect your mood.
Medications aren’t your only choice. Many people benefit from working with a trained mental health professional or participating in a PTSD support group.
I hope you find this article helpful as well as interesting.