Second-Messenger Modifiers (“Mood Stabilizers”)
The drug class of second-messenger modifiers includes agents called “mood stabilizers.” It consists of lithium and some anticonvulsants: valproate, carbamazepine, and lamotrigine. The standard mood stabilizers each have strengths and weaknesses. Lithium is still the gold standard, most proven agent; no other drug has been clearly shown to be more effective than lithium. The clinical pharmacology of specific agents within each class, including their efficacy and side effects, is explored. Specific phenomena that are surveyed include chronic renal insufficiency, liver side effects, polycystic ovarian syndrome, teratogenicity, Stevens-Johnson syndrome, and drug interactions. Benefits for lithium include suicide prevention and possibly dementia prevention.