Management of Comorbid Bipolar Disorder and Substance Abuse

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Rates of alcohol and other substance abuse ordependence disorders are substantially higher in persons with bipolar disorders than in the general population, reaching approximately 61% in patients with bipolar I disorder. As a result, clinicians must be prepared to treat substance  use disorders and bipolar disorder simultaneously. This presentation reviews data from the 4 published randomized, controlled trials of pharmacotherapy (lithium, carbamazepine, valproate, and quetiapine) in this population. Also reviewed are data from promising open-label, uncontrolled trials. While the results of published research have been generally positive and support the efficacy and tolerability of several agents from different classes in patients with a dual diagnosis of bipolar disorder and substance abuse or dependence, more randomized, controlled research is needed.

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J Clin Psychiatry 2006;67(8):e05