TY - JOUR
T1 - Drug abuse and bipolar disorder
T2 - Comorbidity or misdiagnosis?
AU - Sherwood Brown, E.
AU - Suppes, Trisha
AU - Adinoff, Bryon
AU - Rajan Thomas, Nancy
N1 - Funding Information:
Supported, in part, by the National Alliance for Research on Schizophrenia and Depression (NARSAD), the Sarah M. and Charles E. Seay Center for Basic and Applied Research in Psychiatric Illness, John Schemerhorn Psychiatric Fund (ESB) and the Theodore and Vada Stanley Foundation (ESB, TS). The authors thank Susan Mahadi, M.Ed. for proofreading, Vicki Nejtek, Ph.D. for helpful comments and suggestions, Carol Nunley for manuscript preparation, and Kenneth Z. Altshuler, M.D., Stanton Sharp Distinguished Chair, Professor and Chairman, Department of Psychiatry, UT Southwestern Medical Center at Dallas for administrative assistance.
PY - 2001/7
Y1 - 2001/7
N2 - Bipolar disorder is a common, severe and cyclic psychiatric illness. A strong association between alcohol dependence and bipolar disorder has been reported in numerous studies. The abuse of other drugs including cocaine, amphetamines, opiates, cannabis, and prescription medications in bipolar patients is also an important public health concern and has been less extensively investigated. This review examines the abuse of drugs other than alcohol or nicotine in people with bipolar disorder. The high rates of milder affective symptoms but not mania observed in patients in drug abuse treatment settings suggests the symptoms may in many cases be associated with the drug use. However, such patients presenting in psychiatric settings might be suffering from cyclothymic and related attenuated bipolar disorders (type II). Substance abuse may be associated with medication non-compliance, more mixed or dysphoric mania and possibly an earlier onset of affective symptoms and more hospitalizations. The pharmacotherapy of patients with bipolar disorder and drug abuse is examined, including evidence on the use of mood stabilizers, neuroleptics and the newer atypical antipsychotics in this population.
AB - Bipolar disorder is a common, severe and cyclic psychiatric illness. A strong association between alcohol dependence and bipolar disorder has been reported in numerous studies. The abuse of other drugs including cocaine, amphetamines, opiates, cannabis, and prescription medications in bipolar patients is also an important public health concern and has been less extensively investigated. This review examines the abuse of drugs other than alcohol or nicotine in people with bipolar disorder. The high rates of milder affective symptoms but not mania observed in patients in drug abuse treatment settings suggests the symptoms may in many cases be associated with the drug use. However, such patients presenting in psychiatric settings might be suffering from cyclothymic and related attenuated bipolar disorders (type II). Substance abuse may be associated with medication non-compliance, more mixed or dysphoric mania and possibly an earlier onset of affective symptoms and more hospitalizations. The pharmacotherapy of patients with bipolar disorder and drug abuse is examined, including evidence on the use of mood stabilizers, neuroleptics and the newer atypical antipsychotics in this population.
KW - Bipolar disorder
KW - Mood stabilizers
KW - Neuroleptics
KW - Substance abuse
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U2 - 10.1016/S0165-0327(00)00169-5
DO - 10.1016/S0165-0327(00)00169-5
M3 - Review article
C2 - 11356233
AN - SCOPUS:0035036968
SN - 0165-0327
VL - 65
SP - 105
EP - 115
JO - Journal of affective disorders
JF - Journal of affective disorders
IS - 2
ER -