The bipolar patient with comorbid substance use disorder: recognition and management

CNS Drugs
Mark J Albanese, Ronald Pies

Abstract

Bipolar patients with comorbid substance abuse or dependence ("dual diagnosis" patients) represent a major public health problem. Substance abuse generally predicts poor outcome and higher morbidity/mortality in bipolar disorder. For the purposes of this review, open and controlled studies of dual diagnosis assessment and treatment were located through electronic searches of several databases. Pertinent case reports were also evaluated. The results of the search were evaluated in light of the authors' own research on dual diagnosis patients. Literature searching revealed few controlled studies to guide pharmacotherapy of bipolar patients with comorbid substance abuse or dependence. However, preliminary evidence suggests that the best outcomes are usually achieved with antiepileptic mood stabilisers and/or atypical antipsychotics, combined with appropriate psychosocial interventions. The latter may include classical 12-step groups, integrated group therapy or individual psychotherapy. While it is often difficult to determine the precise pathway to comorbid bipolar disorder/substance abuse, it is clear that both disorders must be vigorously treated. This requires a carefully integrated biopsychosocial approach, involving appropri...Continue Reading

References

Jan 1, 1992·Journal of Substance Abuse Treatment·A T McLellanM Argeriou
Jan 1, 1991·The American Journal of Drug and Alcohol Abuse·K BradyG Arana
Sep 1, 1993·Journal of Studies on Alcohol·G WinokurR Fowler
Jan 15, 1999·Journal of Substance Abuse Treatment·R D WeissS F Greenfield
Jul 11, 2001·The American Journal on Addictions·M J Albanese
Jan 10, 2003·Bipolar Disorders·E Sherwood BrownLeonardo Bobadilla
Jun 17, 2003·PharmacoEconomics·Leah KleinmanDennis Revicki
Jun 30, 2005·Journal of Psychiatric Practice·Ronald Pies

❮ Previous
Next ❯

Citations

Sep 22, 2007·The World Journal of Biological Psychiatry : the Official Journal of the World Federation of Societies of Biological Psychiatry·Isabella PacchiarottiEduard Vieta
Jan 7, 2011·Issues in Mental Health Nursing·Terry Dionne Ward
Jun 7, 2012·Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology·E Sherwood BrownThomas J Carmody
Sep 5, 2012·Annals of General Psychiatry·Icro MaremmaniHagop S Akiskal
Sep 9, 2010·The Journal of Nervous and Mental Disease·Trine Vik LagerbergIngrid Melle
May 6, 2006·Journal of Affective Disorders·Icro MaremmaniHagop S Akiskal

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antipsychotic Drugs

Antipsychotic drugs are a class of medication primarily used to manage psychosis (including delusions, hallucinations, paranoia or disordered thought), principally in schizophrenia and bipolar disorder. Discover the latest research on antipsychotic drugs here

Bipolar Disorder

Bipolar disorder is characterized by manic and/or depressive episodes and associated with uncommon shifts in mood, activity levels, and energy. Discover the latest research this illness here.