How Long Should I Continue with Mood Stabilisers?
The decision to remain on mood stabilisers depends on a multitude of factors, tailored to your individual needs and discussed with your healthcare provider.
Concerns such as symptom control, side effects, and past medicinal history should inform your choice.
Here are some general timeframes your doctor might explore with you :
- For those managing bipolar disorder, lithium is often recommended for an extended term to minimise relapse risk. A minimum commitment of six months is usually advised, to accurately assess the drug's efficacy.
- If you've been stable for a 3-5 year span while on lithium, this might be an appropriate time to converse with your healthcare provider about potentially ceasing medication.
- When you opt to discontinue mood stabilisers, tapering them off gradually is essential. Post-discontinuation, monitoring should persist for a minimum of two years.
A Safe Pathway to Discontinuation
If you're contemplating stopping your medication, consult your doctor for a personalised withdrawal plan, which should encompass relapse identification and management strategies.
Monitoring your emotional state as you transition off mood stabilisers is vital; consider utilising a mood diary for this. Links to online mood diaries are available on our resources page.
Lithium: The Exit Strategy
Per NICE guidelines, a tapered lithium reduction over at least a four-week span is advised. An optimal timeline extends up to three months to mitigate relapse risks.
During this period, your healthcare provider should vigilantly monitor for emerging signs of mania or depression. Physical withdrawal symptoms are generally absent with lithium.
Stopping Anticonvulsant
When discontinuing anticonvulsants, NICE recommends a gradual reduction spanning at least four weeks. Beware of potential withdrawal symptoms such as :
- Emotional fluctuations
- anxiety, and irritability
- Headaches and dizziness
- Gastrointestinal disturbances
- Respiratory issues
- Liver complications
- Cognitive difficulties
- Sensory changes
- Sleep disruptions
- Weight fluctuations
- Muscular symptoms
Valproate: Stop with Caution
Valproate comes with unique cessation risks. Abrupt withdrawal is hazardous; consult your doctor for a safe exit strategy. Valproate should only be prescribed under a pregnancy prevention programme. If you suspect pregnancy, consult your healthcare provider straight away.
Antipsychotic Tapering
NICE guidelines advocate for a phased antipsychotic dose reduction over a minimum of four weeks. For details on potential withdrawal symptoms, please consult our dedicated section on antipsychotic medication.