The Prevalence and Management of Side Effects of Lithium and Anticonvulsants as Mood Stabilizers in Bipolar Disorder from a Clinical Perspective

The document from 2013 reviews the side effects of mood stabilizers such as lithium, valproate, carbamazepine, and lamotrigine in bipolar disorder treatment, noting that side effects contribute to medication nonadherence with rates ranging from 10 to 60%. It reports that hypothyroidism is a common side effect of lithium, affecting 0-23% of patients, and hair loss is reported in at least 10% of patients on lithium, 6% on carbamazepine, and up to 28% on high doses of valproate. Cognitive and sexual side effects are also concerns, with lithium affecting memory and motor speed, and anticonvulsants associated with sexual dysfunction. Hepatotoxicity is rare with valproate, but hyperammonemia is reported in 16-100% of patients. Teratogenic risks are present, with lithium having a low risk of cardiovascular malformations, while valproate is linked to a higher risk of neural tube defects. The document stresses the importance of monitoring and managing side effects to improve patient adherence and calls for more research on the efficacy of interventions, particularly in elderly patients.