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Mood Stabilizers and Borderline Personality Disorder

Mood stabilizers may be used to reduce anger, anxiety, depression, impulsivity (acting without thinking), or attempts at self-harm associated with borderline personality disorder.1 A few medicines commonly used as mood stabilizers are:

Mood stabilizers are taken by mouth as pills or capsules.

These medicines help stabilize certain brain chemicals called neurotransmitters, which control emotional temperament and behavior. Balancing these brain chemicals may reduce symptoms of borderline personality disorder.

Carbamazepine

Carbamazepine is an antiseizure medicine that is used as a mood stabilizer.

It causes different side effects than lithium. It can interact with other medicines, and you need to be watched carefully when you are taking this medicine. Side effects of carbamazepine can include a dry mouth and throat, constipation, unsteadiness, drowsiness, loss of appetite, nausea, and vomiting.

People who take carbamazepine need to have regular tests to measure the amount of carbamazepine in their blood. They also need to have tests to check liver function and blood cell count.

Carbamazepine should not be used along with monoamine oxidase inhibitors (MAOIs), because serious—sometimes fatal—reactions can occur.

Carbamazepine can interact with birth control pills (oral contraceptives), making them ineffective in preventing pregnancy.

Avoid drinking alcohol while taking carbamazepine. It can increase some of the side effects of carbamazepine. And drinking alcohol with this medicine can increase your risk for seizures.

Grapefruit and grapefruit juice may interact with carbamazepine. This may have dangerous effects. Talk with your doctor about the use of grapefruit products.

Divalproex

Divalproex is an antiseizure medicine that is used as a mood stabilizer.

It can cause side effects such as drowsiness, nausea, trouble sleeping, dizziness, or weight gain. Other side effects that are more serious can occur but are rare. They include liver problems, pancreatitis, and a severe allergic reaction.

People who take divalproex need to have regular tests to measure the amount of divalproex in their blood. They also need to have tests to check liver function and blood cell count.

Lithium

Lithium can be taken for a longer period of time or used as maintenance therapy.

Side effects of lithium may include nausea, vomiting, diarrhea, trembling, and an increased thirst and need to urinate. Weight gain in the first few months of use is common, along with drowsiness and a metallic taste in the mouth.

Side effects of lithium that are more serious can include blacking out, slurred speech, thyroid dysfunction, kidney dysfunction, changes in heart rhythm or other heart problems, and an increase in the number of white blood cells (not usually caused by an infection).

People who take lithium need to have regular tests to measure the amount of lithium in their blood. They also need to have tests to check thyroid function, kidney function, and blood cell count.

High blood levels of lithium can be life-threatening. Sometimes other prescription and nonprescription medicines cause higher- or lower-than-expected amounts of lithium in the blood. If you and your doctor decide you should take lithium, it is important to tell your doctor about all of the other medicines you are taking.

Do not stop taking these medicines suddenly. You should taper off of these drugs slowly with the help of your doctor, to avoid negative and serious side effects. While you are taking carbamazepine and divalproex, your doctor will need to test your liver now and then to see how well it's working. If you are taking lithium, your doctor may also test your thyroid and kidneys.

Mood stabilizers may interact with other medicines. Tell your doctor all of the medicines you are taking and ask about possible interactions.

FDA advisory. The U.S. Food and Drug Administration (FDA) has issued a warning on antiseizure medicines and the risk of suicide and suicidal thoughts. The FDA does not recommend that people stop using these medicines. Instead, people who take antiseizure medicine should be watched closely for warning signs of suicide. People who take antiseizure medicine and who are worried about this side effect should talk to a doctor.

Citations

  1. National Institute for Health and Clinical Excellence (2009). Borderline personality disorder: Treatment and management. London: National Institute for Health & Clinical Excellence (NICE). Available online: http://publications.nice.org.uk/borderline-personality-disorder-cg78.

By Healthwise Staff
Primary Medical Reviewer Sarah Marshall, MD - Family Medicine
Specialist Medical Reviewer Lisa S. Weinstock, MD - Psychiatry
Current as of March 8, 2013

WebMD Medical Reference from Healthwise

Last Updated: March 08, 2013
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.

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