Mood stabilisers including lithium

Domain IX · Biomedical, neuro & digital

What it is

"Mood stabilisers" is a clinical umbrella term, not a single therapy: medicines prescribed to treat mania or hypomania, and to reduce the risk of further mood episodes in bipolar disorder. In current labelling and guidelines the core group is lithium plus three anticonvulsants with bipolar…

Format

• There are no therapy "phases" in the labelling. The stages below follow the treatment course as NICE and the labels describe it, with the therapist's tasks at each.
• Format and session count. Medicine reviews are set by the prescribing team. NICE recommends that psychological interventions for bipolar disorder be structured, specifically designed for it, with a published evidence-based manual, delivered by therapists trained and experienced in bipolar disorder;…

Evidence status, as the guide reports it

• Format and session count. Medicine reviews are set by the prescribing team. NICE recommends that psychological interventions for bipolar disorder be structured, specifically designed for it, with a published evidence-based manual, delivered by therapists trained and experienced in bipolar disorder;…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• carers policing medicine taking; conflicts over confidentiality.
• low-salt or crash diets; heavy alcohol use; dehydration during mania.
• minimising ("it's just a bug"); the review actually happening; follow up next session.
• shame or fear leading to secret stopping; unplanned pregnancy (urgent specialist contact).
• consent drifting out of date; the client using you as a go-between to avoid the prescriber.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.