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J Addict Dis. 2009 Oct;28(4):348-55. doi: 10.1080/10550880903182994.

Antidepressant-induced mania with concomitant mood stabilizer in patients with comorbid substance abuse and bipolar disorder.

Author information

1
Department of Psychiatry and Behavioral Sciences, George Washington School of Medicine and Health Sciences, 2150 Pennsylvania Ave., NW, Washington, DC 20037, USA. dlieberman@mfa.gwu.edu

Abstract

Antidepressant use in the treatment of bipolar disorder is controversial due the risks of affective switching and cycle acceleration. Studies of non-comorbid samples suggest that the risk can be mitigated with the use of a concomitant mood stabilizer. However, the majority of patients with bipolar disorder will experience a comorbid substance use disorder and little is known about these individuals because they are typically excluded from clinical trials. Patients entering a substance abuse treatment program who had a history of bipolar disorder were interviewed to evaluate antidepressant-induced affective switching with and without concomitant mood stabilizer. Among 41 comorbid participants, the total lifetime antidepressant-induced switch rate was 76%. The switch rate was 56% for patients taking a mood stabilizer and an antidepressant concomitantly. There was no difference between patients with bipolar I and bipolar II disorders.

PMID:
20155604
DOI:
10.1080/10550880903182994
[Indexed for MEDLINE]

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