Bipolar disorder is a severe and often chronic disorder with lifetime prevalence rates of bipolar spectrum disorders of up to 6.5% in the general population. Patients with bipolar disorder frequently report co-occurring substance use disorders, and the rates of alcohol and other substance use disorders are significantly higher in persons with bipolar disorder than in the general population. The present review discusses why people with bipolar disorder use substances, provides an overview of the impact of alcohol and other substance use on the course of bipolar disorder, and outlines the treatment options currently available to patients with co-occurring bipolar disorder and substance abuse. Our aim is to summarize the existing data on the pharmacologic treatment options and to include the most recent published data whenever possible. Three randomized, placebo-controlled studies of dual-diagnosis patients treated with carbamazepine, lithium, and valproate are discussed. The results are generally positive and support the use of these agents in dual-diagnosis patients. Open-label studies are also presented, and the need for controlled data is outlined. The review also briefly discusses the psychotherapeutic approaches to patients with comorbid bipolar and substance use disorders.
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Cambridge Hlth Alliance, Addict Serv, Cambridge, MA USA
Harvard Univ, Sch Med, Boston, MA USACambridge Hlth Alliance, Addict Serv, Cambridge, MA USA
Albanese, Mark J.
Suh, Jesse J.
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Univ Penn, Dept Psychiat, Ctr Studies Addict, Philadelphia, PA 19104 USACambridge Hlth Alliance, Addict Serv, Cambridge, MA USA
Suh, Jesse J.
Lefebvre, Rachel
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Tewksbury Hosp, Tewksburg, MA USACambridge Hlth Alliance, Addict Serv, Cambridge, MA USA
Lefebvre, Rachel
Clodfelter, Reynolds C., Jr.
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Southlight Inc, Raleigh, NC USA
Duke Univ, Durham, NC USACambridge Hlth Alliance, Addict Serv, Cambridge, MA USA
Clodfelter, Reynolds C., Jr.
Ghaemi, S. Nassir
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Emory Univ, Dept Psychiat, Bipolar Disorder Res Program, Atlanta, GA 30322 USACambridge Hlth Alliance, Addict Serv, Cambridge, MA USA
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Univ Roma La Sapienza, Dept Psychol, I-00185 Rome, ItalyUniv Roma La Sapienza, Dept Psychol, I-00185 Rome, Italy
de Marco, Adriano
Scozia, Gabriele
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Univ Roma La Sapienza, Dept Psychol, I-00185 Rome, Italy
Univ Roma La Sapienza, PhD Program Behav Neurosci, I-00185 Rome, ItalyUniv Roma La Sapienza, Dept Psychol, I-00185 Rome, Italy
Scozia, Gabriele
Manfredi, Lucia
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Univ Roma La Sapienza, Dept Psychol, I-00185 Rome, ItalyUniv Roma La Sapienza, Dept Psychol, I-00185 Rome, Italy
Manfredi, Lucia
Conversi, David
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Univ Roma La Sapienza, Dept Psychol, I-00185 Rome, ItalyUniv Roma La Sapienza, Dept Psychol, I-00185 Rome, Italy