Antimanic agents

Antimanic agents help to calm episodes of mania in people with bipolar disorder, and they may be used in other conditions where people periodically display periods of great excitement or euphoria, delusions, or over-activity. The term mood stabilizer may also be used to describe an antimanic agent, although technically, antimanic agents are those mood stabilizers that only treat episodes of mania, not depression. Three mood stabilizers that are effective at treating both mania and depression are lamotrigine, lithium, and quetiapine.

Lithium, some anticonvulsants (such as carbamazepine, lamotrigine, valproate), and some atypical antipsychotics (for example, aripiprazole, olanzapine, quetiapine) are the most common drugs used for their mood stabilizing effects and in the control of mania.

Although experts do not fully understand how antimanic agents work to stabilize episodes of mania, it is believed that they either influence levels of chemical neurotransmitters in the brain, such as dopamine, GABA, norepinephrine, or serotonin; or, when used as anticonvulsants, reduce the excitability of nerve impulses in the brain. An effective antimanic agent should:

• Reduce acute episodes of mania to a more manageable level
• Relieve symptoms such as agitation, inappropriate behavior, and sleep problems
• Prevent symptom relapses and hospitalization.

Side effects vary depending on the type of antimanic agent used.