- Body system
- Mental health
- Drug cards
- 1 in this guide
Drugs in this class
Other examples: Valproate, Carbamazepine, Lamotrigine.
How mood stabilizers work
Lithium's mechanism is not fully understood. Some antiepileptic drugs (valproate, carbamazepine, lamotrigine) also stabilize mood; second-generation antipsychotics are often used as well.
Uses
- Acute mania
- Maintenance treatment of bipolar disorder
- Bipolar depression (lamotrigine, some antipsychotics)
Adverse effects
- Lithium: fine tremor, thirst, polyuria, weight gain, hypothyroidism, toxicity
- Valproate: liver injury, pancreatitis, birth defects
- Carbamazepine: blood dyscrasias, hyponatremia, serious rash
- Lamotrigine: serious rash (Stevens-Johnson syndrome)
Nursing considerations
- Monitor lithium levels (commonly 0.6 to 1.2 mEq/L for maintenance), kidney function, thyroid function and sodium.
- Assess for signs of toxicity: vomiting, diarrhea, coarse tremor, ataxia, confusion.
- Check for drugs that raise lithium levels: NSAIDs, thiazide diuretics, ACE inhibitors.
Patient teaching
- Keep fluid and salt intake steady.
- Report vomiting, diarrhea or heavy sweating.
- Keep every blood test appointment.
Mood stabilizers NCLEX practice questions
Answer each question to see the rationale.
3 questions. Choose an answer to see the rationale.
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A patient on lithium has a level of 2.1 mEq/L with vomiting and coarse tremor. What is the priority?
Show answer
Answer A: Hold lithium and notify the provider: these are signs of toxicity A level above the therapeutic range with GI and neurologic symptoms indicates lithium toxicity.
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Which over-the-counter drug can raise lithium levels?
Show answer
Answer A: Ibuprofen NSAIDs reduce lithium excretion by the kidneys and can cause toxicity.
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What teaching about diet is correct for a patient on lithium?
Show answer
Answer B: Keep salt and fluid intake consistent Low sodium or dehydration makes the kidney keep more lithium; consistency keeps levels stable.
Frequently asked questions
What are mood stabilizers?
Mood stabilizers treat bipolar disorder. Lithium is the classic drug, with a narrow therapeutic range that depends on hydration and sodium balance.
How do mood stabilizers work?
Lithium's mechanism is not fully understood. Some antiepileptic drugs (valproate, carbamazepine, lamotrigine) also stabilize mood; second-generation antipsychotics are often used as well.
What are examples of mood stabilizers?
Lithium, Valproate, Carbamazepine and Lamotrigine.
What are the nursing considerations for mood stabilizers?
Monitor lithium levels (commonly 0.6 to 1.2 mEq/L for maintenance), kidney function, thyroid function and sodium. Assess for signs of toxicity: vomiting, diarrhea, coarse tremor, ataxia, confusion.