Available Treatment for Bipolar Disorder with Co-Occurring Substance and Alcohol Use Disorders: A Review

Bipolar disorder (BD) with co-occurring substance or alcohol use disorders (SUD/AUD) is associated with a more severe course of illness, lower psychosocial functioning and unfavorable response to treatment. BD patients with a dual-diagnosis were largely excluded from previous clinical outcome studies due to methodological considerations; however, in recent years, a growing interest in dually-diagnosed BD patients has increased the number of studies that explored efficacious interventions for this vulnerable population. The current review examined these studies and concluded that preliminary data point to the benefits of psychosocial interventions adhering to the principles of integrated care. The results of pharmacological studies support the use of naltrexone with co-occurring AD; whereas, findings associated with other agents remain inconclusive at this point. The paper further discusses issues related to theoretical developments with practical implications for improving clinical and functional outcome for dually-diagnosed BD patients.