Mood Stabilizers in Bipolar Disorder
Mood stabilisers are the foundation of long-term treatment for bipolar disorder — the medications that reduce the frequency and severity of mood episodes and help people stay well. But they are not all the same, and choosing the right one is an individual decision. This page explains the main options and how they are selected and monitored by Dr. Anindo Mitra (MBBS, MD Psychiatry, JIPMER), available in-person in Gurugram and online across India.
Who this is for
This page is for people with bipolar disorder (or their families) who want to understand what mood stabilisers do, the differences between them, and what taking one involves. If you are newly diagnosed or reviewing your treatment, this will help you have an informed conversation.
What mood stabilisers do
Mood stabilisers work to prevent the swings of bipolar disorder — both the highs (mania or hypomania) and the lows (depression) — and to reduce the risk of relapse over time. Some are better at treating or preventing the "up" phases, others the "down" phases, which is one reason the choice is tailored to your particular pattern of illness.
The main options
Following the practice's "cafeteria approach," Dr. Mitra explains each relevant option — how it works, its benefits, its side effects and monitoring, and how it fits your situation — and you decide together.
- Lithium. One of the most effective mood stabilisers, with strong evidence for preventing relapse and reducing suicide risk. It requires regular blood-level and organ monitoring. Because it is such an important option, it has its own detailed page: Lithium Treatment for Bipolar Disorder.
- Valproate. Effective, particularly for manic episodes. It requires monitoring and is generally avoided in women of childbearing potential because of significant risks in pregnancy — this is discussed carefully.
- Lamotrigine. Especially useful for preventing the depressive phase of bipolar disorder. It must be started slowly and increased gradually to reduce the risk of a serious rash.
- Carbamazepine. An alternative mood stabiliser used in specific situations, with its own monitoring requirements and drug interactions.
- Certain atypical antipsychotics. Several are effective as mood stabilisers, for acute episodes and for maintenance, sometimes alone and sometimes combined with the above.
How the right one is chosen
The choice depends on factors such as: whether your illness tends more toward highs or lows, your history of response to previous medication, side-effect considerations, other medical conditions, and — very importantly — pregnancy plans. Safety in pregnancy and breastfeeding is a central part of the discussion for anyone who could become pregnant; see Perinatal Psychiatry.
Monitoring and safety
Mood stabilisers require ongoing monitoring — blood tests for some (levels and organ function), and regular review of effectiveness and side effects for all. This is a normal, manageable part of treatment and is explained clearly. Mood stabilisers should not be stopped abruptly, as this can trigger relapse; any change is planned, and where reducing medication is appropriate it is done gradually (see deprescribing and medication review).
In-person in Gurugram and online across India
Available in-person at Athena Behavioural Health, Sector 47, Gurugram, and online across India via Zoom or Google Meet, in English, Hindi, Bengali, and Tamil. Blood-test monitoring is arranged locally where needed.
Safety and urgent help
If you experience severe side effects, signs of toxicity, or thoughts of self-harm, seek help promptly via your prescriber, emergency services, your nearest hospital, or Tele-MANAS on 14416. This page is educational and does not replace an individual consultation.
Book a consultation
- WhatsApp: +91 93104 65035
- Practo: Dr. Anindo Mitra on Practo
See fees · bipolar disorder treatment · lithium treatment
Frequently asked questions
What is the best mood stabiliser for bipolar disorder? There is no single best one — it depends on your pattern of illness, history, side-effect considerations, and pregnancy plans. Lithium has particularly strong evidence for relapse and suicide-risk reduction, but the right choice is individual.
Do mood stabilisers have to be taken long-term? Usually yes, to prevent relapse, though this is individual and reviewed regularly. Doses are kept to the minimum effective level, and medication is never stopped abruptly.
Are mood stabilisers safe in pregnancy? This varies significantly by medication — some carry important risks (for example valproate) and others are managed differently. Anyone who could become pregnant should discuss this early; see the perinatal psychiatry page.
Why do some mood stabilisers need blood tests? For medications like lithium, blood tests check that the level is effective but not too high, and monitor organ function. This makes long-term treatment safe.
Can I switch mood stabilisers if mine isn't working? Yes. If a medication is not effective or not tolerated, there are several alternatives, and switching is planned carefully to maintain stability.