Self-Medication, Bipolar Disorders, and Stimulant Dependence

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Sir: In the August 2008 issue of the Journal, Nejtek et al. present findings that both quetiapine and risperidone produced improvement in manic, mixed, and depressive symptoms. In turn, symptom reduction was associated with reduced drug cravings in patients with co-occurring bipolar and stimulant dependence disorders, albeit not affecting drug use. These are important findings in that (1) there is an extraordinarily high incidence of co-occurrence of substance abuse in general associated with bipolar disorders and, in particular, a high cooccurrence of stimulant abuse; and (2) there are few if any specific effective psychopharmacologic treatments for stimulant dependence.

J Clin Psychiatry 2009;70(6):935-936