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Starting and stopping mood stabilizers 

From: Understanding psychiatric medications: Mood stabilizers - Information for consumers, families and friends (© 2009, 2012 CAMH)

How long should I take mood stabilizers?

When you start taking mood stabilizers, it may be two weeks or more before you notice their effect, and four to six weeks before they reach their full effect. It’s important to give them time to work. Once your symptoms are under control, you will be encouraged to continue to take mood stabilizers for at least six months, and probably longer. How much longer varies from person to person.

Mood stabilizers can help prevent further episodes of mania or depression. In other words, staying on these medications for the long term can help to keep you well. Going off mood stabilizers, on the other hand, can greatly increase your chances of having another episode.

Once you have been taking mood stabilizers for a while and you are feeling well, you may do fine on a lower “maintenance” dose. Talk to your doctor if you would like to try this.

Are mood stabilizers addictive?

Drugs that are addictive produce a feeling of euphoria, a strong desire to continue using the drug, and a need to increase the amount used to achieve the same effect. Mood stabilizers do not have these effects.

While mood stabilizers are not addictive, when you take them (or any drug) over months or years, your body adjusts to the presence of the drug. If you then stop using the drug, especially if you stop suddenly, the absence of the drug may result in withdrawal effects or in return of symptoms. With mood  stabilizers, the withdrawal effects are generally mild; the greatest risk with stopping these drugs is the return of symptoms.

How do I cut down or stop taking mood stabilizers?

Whether you want to cut down your dose or stop taking a medication, the same rule applies: go slowly. Sudden changes in your dose can greatly increase your risk of having another mood episode.

The first step is to ask yourself if this is the right time. Are you feeling well? Is the level of stress in your life manageable? Do you feel supported by your family and friends?

If you think you’re ready, talk to your doctor. If your doctor doesn’t agree, find out why. If you are not satisfied with his or her reasons, you may want to see another doctor for a second opinion.

If your doctor does agree, he or she will advise you not to skip doses but to reduce your dose gradually—usually by about 10 per cent at a time—with at least two to three weeks between each reduction. This process of cutting back can take several months. Using a pill cutter or a liquid form of your medication can help you to cut your dose down in small amounts.

If you want to stop taking more than one medication, your doctor will usually suggest that you lower the dose of one drug at a time.

As you cut down, if you start to feel unwell, let your doctor know. You may want to go back up with your dose. Find the dose that works best for you.

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