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

Daniel Z. Lieberman, George Kolodner, Suena H. Massey, Kenneth P. Williams

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)348-355
Number of pages8
JournalJournal of Addictive Diseases
Volume28
Issue number4
DOIs
StatePublished - Oct 1 2009

Keywords

  • Affective switching
  • Antidepressant-induced mania
  • Bipolar II
  • Bipolar depression
  • Bipolar disorder
  • Substance use disorder

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health

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