Medications for mood stabilisation The following medications are used as mood stabilisers or for mood maintenance. Each acts in a different way in the brain to prevent your mood becoming unstable. They may also act to improve your mood if depressed or calm you down if high. Lithium Carbamazepine Divalproex Valproic acid Olanzapine Quetiapine How do they work? Their exact mechanism is not known and they probably work in different ways. They may have a common action to change the level of mood changing chemicals and boost levels of a “brain fertiliser hormone” called Brain Derived Neurotrophic Factor (BDNF). This is boosted particularly in critical areas of the brain responsible for mood regulation, or an area known as the limbic system and prefrontal cortex. Blood Monitoring Many of the mood stabilisers require some kind of regular blood monitoring to check the drug’s plasma level. Lithium can affect organs such as the kidney, thyroid and liver. Regular blood tests can monitor this. Physical health When you start on a mood stabiliser or antipsychotic you may have tests before and then at regular intervals afterwards. Olanzapine and quetiapine can cause changes in your metabolism leading to weight gain, diabetes or raised cholesterol. Initially your weight gain, blood pressure and blood will be tested every three months for the first year and then each year thereafter. It is important that these tests are done to detect changes early so any problems can be picked up and treated.