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[Pharmacology](https://durgical.com/en/pharmacology/) · Class

# Mood stabilizers

Medicines that treat mania and prevent new episodes of bipolar disorder. Lithium is the classic one; valproate and others also act here.

Updated 2026-11-01

## What they are

A clinical group rather than a chemical one: lithium, some antiseizure medicines (valproate, carbamazepine, lamotrigine) and several atypical antipsychotics are used to control mania or bipolar depression and to prevent relapse.

## Mechanism of action

Mechanisms differ. Lithium's is not fully known; leading ideas are inhibition of inositol monophosphatase (dampening phosphatidylinositol signalling) and inhibition of GSK-3. Valproate also lowers brain inositol and inhibits GSK-3, besides its antiseizure actions.

Target: Inositol monophosphatase and GSK-3 (lithium; proposed)

## Key points

- Lithium has a narrow therapeutic range: toxicity can appear at levels close to the effective ones, so serum levels are measured regularly.
- Dehydration, low sodium, diuretics, NSAIDs and ACE inhibitors or ARBs raise lithium levels.
- Long-term lithium can cause hypothyroidism, nephrogenic diabetes insipidus, and hypercalcaemia with hyperparathyroidism.
- Valproate and carbamazepine are teratogenic; lithium in early pregnancy has been linked to Ebstein's anomaly, with a smaller risk than once thought.

## Drugs in this class

- [**Lithium carbonate** The classic mood stabilizer for bipolar disorder. Its safe range is narrow, so blood levels are checked and toxicity… Inositol monophosphatase and GSK-3 (proposed)](https://durgical.com/en/pharmacology/lithium-carbonate/)

## Others in the class

- Valproic acid (valproate)
- Carbamazepine
- Lamotrigine

## Test yourself

Think of the answer, then tap the question to see it.

## Why do thiazide diuretics and NSAIDs raise lithium levels?

Lithium is handled by the kidney like sodium; drugs that reduce renal sodium or lithium excretion make the kidney retain more lithium.

## Which endocrine problem is most typical of long-term lithium?

Hypothyroidism; lithium is concentrated in the thyroid and inhibits hormone synthesis and release.

## What causes polyuria and thirst in a patient on lithium?

Lithium reduces the kidney's response to antidiuretic hormone, sometimes up to nephrogenic diabetes insipidus.

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Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [DailyMed - LITHIUM CARBONATE tablet](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d20ed2aa-aa56-4709-9e7a-9243c71465c9) (DailyMed (U.S. National Library of Medicine), 2026); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 19 (McGraw Hill, 2023).

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Representative model, for educational purposes only.

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