<Li> Lithium--Lithium is the "classic" mood stabilizer, the first to be approved by the US FDA, and still popular in treatment . Therapeutic drug monitoring is required to ensure lithium levels remain in the therapeutic range: 0.6 or 0.8 - 1.2 mEq / L (or millimolar). Signs and symptoms of toxicity include nausea, vomiting, diarrhea, and ataxia . The most common side effects are lethargy and weight gain . The less common side effects of using lithium are blurred vision, a slight tremble in the hands, and a feeling of being mildly ill . In general, these side effects occur in the first few weeks after commencing lithium treatment . These symptoms can often be improved by lowering the dose . </Li> <P> Many agents described as "mood stabilizers" are also categorized as anticonvulsants . The term "anticonvulsant mood stabilizers" is sometimes used to describe these as a class . Although this group is also defined by effect rather than mechanism, there is at least a preliminary understanding of the mechanism of most of the anticonvulsants used in the treatment of mood disorders . </P> <Ul> <Li> Valproate--Available in extended release form . This drug can be very irritating to the stomach, especially when taken as a free acid . Liver function and CBC should be monitored . </Li> <Li> Lamotrigine--Particularly effective for bipolar depression . Usual dose is 100--200 mg daily, which can be built up by 25 mg every 2 weeks . The patient should be monitored for signs and symptoms of Stevens--Johnson syndrome, a very rare but potentially fatal skin condition . </Li> <Li> Carbamazepine--CBC should be monitored, as carbamazepine can lower white blood cell count . Therapeutic drug monitoring is required . Carbamazepine was approved by the US Food and Drug Administration as a bipolar disorder treatment in 2005, but had been widely used previously . </Li> </Ul> <Li> Valproate--Available in extended release form . This drug can be very irritating to the stomach, especially when taken as a free acid . Liver function and CBC should be monitored . </Li>

Mood-stabilizing drugs that are known to enhance the activity of gaba