Management of Comorbid Bipolar Disorder and Substance Abuse

Article Abstract

Rates of alcohol and other substance abuse ordependence disorders are substantially higher in persons with bipolar disordersthan in the general population, reaching approximately 61% in patients withbipolar I disorder. As a result, clinicians must be prepared to treatsubstance  use disorders and bipolar disorder simultaneously. This presentationreviews data from the 4 published randomized, controlled trials ofpharmacotherapy (lithium, carbamazepine, valproate, and quetiapine) in thispopulation. Also reviewed are data from promising open-label, uncontrolledtrials. While the results of published research have been generally positiveand support the efficacy and tolerability of several agents from differentclasses in patients with a dual diagnosis of bipolar disorder and substanceabuse or dependence, more randomized, controlled research is needed.