Name a mood stabilizer often used as an alternative or supplement to lithium.

• A. Diazepam
• B. Fluoxetine
• C. Quetiapine
• D. Valproic acid

Answer: (D)

Mood stabilization in bipolar disorder centers on medications that dampen mood swings and prevent manic or depressive episodes. When lithium isn’t suitable or as an additional option, valproic acid is a common choice to use as an alternative or augmentation. It helps control mania and provides maintenance coverage, and it’s particularly helpful in patients with rapid cycling or those who don’t tolerate lithium well. Mechanistically, valproic acid increases GABA activity and reduces neuronal excitability, which contributes to its stabilizing effect on mood. Diazepam is a short-term anxiolytic and doesn’t provide long-term mood stabilization; fluoxetine is an antidepressant that can trigger mania in bipolar disorder; and while quetiapine has mood-stabilizing uses, the classic association for an alternative to lithium is valproic acid.