Bipolar Disorder and Comorbid Use of Illicit Substances

Substance use disorders (SUD) are highly prevalent in bipolar disorder (BD) and significantly affect clinical outcomes. Incidence and management of illicit drug use differ from alcohol use disorders, nicotine use of behavioral addictions. It is not yet clear why people with bipolar disorder are at h...

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Autores principales:	Ulrich W. Preuss, Martin Schaefer, Christoph Born, Heinz Grunze
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	bipolar disorders substance use disorders cocaine cannabis illicit drugs mania Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/c067e1670cb24e36a0da6952fab3de06
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spelling	oai:doaj.org-article:c067e1670cb24e36a0da6952fab3de062021-11-25T18:18:59ZBipolar Disorder and Comorbid Use of Illicit Substances10.3390/medicina571112561648-91441010-660Xhttps://doaj.org/article/c067e1670cb24e36a0da6952fab3de062021-11-01T00:00:00Zhttps://www.mdpi.com/1648-9144/57/11/1256https://doaj.org/toc/1010-660Xhttps://doaj.org/toc/1648-9144Substance use disorders (SUD) are highly prevalent in bipolar disorder (BD) and significantly affect clinical outcomes. Incidence and management of illicit drug use differ from alcohol use disorders, nicotine use of behavioral addictions. It is not yet clear why people with bipolar disorder are at higher risk of addictive disorders, but recent data suggest common neurobiological and genetic underpinnings and epigenetic alterations. In the absence of specific diagnostic instruments, the clinical interview is conducive for the diagnosis. Treating SUD in bipolar disorder requires a comprehensive and multidisciplinary approach. Most treatment trials focus on single drugs, such as cannabis alone or in combination with alcohol, cocaine, or amphetamines. Synopsis of data provides limited evidence that lithium and valproate are effective for the treatment of mood symptoms in cannabis users and may reduce substance use. Furthermore, the neuroprotective agent citicoline may reduce cocaine consumption in BD subjects. However, many of the available studies had an open-label design and were of modest to small sample size. The very few available psychotherapeutic trials indicate no significant differences in outcomes between BD with or without SUD. Although SUD is one of the most important comorbidities in BD with a significant influence on clinical outcome, there is still a lack both of basic research and clinical trials, allowing for evidence-based and specific best practices.Ulrich W. PreussMartin SchaeferChristoph BornHeinz GrunzeMDPI AGarticlebipolar disorderssubstance use disorderscocainecannabisillicit drugsmaniaMedicine (General)R5-920ENMedicina, Vol 57, Iss 1256, p 1256 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	bipolar disorders substance use disorders cocaine cannabis illicit drugs mania Medicine (General) R5-920
spellingShingle	bipolar disorders substance use disorders cocaine cannabis illicit drugs mania Medicine (General) R5-920 Ulrich W. Preuss Martin Schaefer Christoph Born Heinz Grunze Bipolar Disorder and Comorbid Use of Illicit Substances
description	Substance use disorders (SUD) are highly prevalent in bipolar disorder (BD) and significantly affect clinical outcomes. Incidence and management of illicit drug use differ from alcohol use disorders, nicotine use of behavioral addictions. It is not yet clear why people with bipolar disorder are at higher risk of addictive disorders, but recent data suggest common neurobiological and genetic underpinnings and epigenetic alterations. In the absence of specific diagnostic instruments, the clinical interview is conducive for the diagnosis. Treating SUD in bipolar disorder requires a comprehensive and multidisciplinary approach. Most treatment trials focus on single drugs, such as cannabis alone or in combination with alcohol, cocaine, or amphetamines. Synopsis of data provides limited evidence that lithium and valproate are effective for the treatment of mood symptoms in cannabis users and may reduce substance use. Furthermore, the neuroprotective agent citicoline may reduce cocaine consumption in BD subjects. However, many of the available studies had an open-label design and were of modest to small sample size. The very few available psychotherapeutic trials indicate no significant differences in outcomes between BD with or without SUD. Although SUD is one of the most important comorbidities in BD with a significant influence on clinical outcome, there is still a lack both of basic research and clinical trials, allowing for evidence-based and specific best practices.
format	article
author	Ulrich W. Preuss Martin Schaefer Christoph Born Heinz Grunze
author_facet	Ulrich W. Preuss Martin Schaefer Christoph Born Heinz Grunze
author_sort	Ulrich W. Preuss
title	Bipolar Disorder and Comorbid Use of Illicit Substances
title_short	Bipolar Disorder and Comorbid Use of Illicit Substances
title_full	Bipolar Disorder and Comorbid Use of Illicit Substances
title_fullStr	Bipolar Disorder and Comorbid Use of Illicit Substances
title_full_unstemmed	Bipolar Disorder and Comorbid Use of Illicit Substances
title_sort	bipolar disorder and comorbid use of illicit substances
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/c067e1670cb24e36a0da6952fab3de06
work_keys_str_mv	AT ulrichwpreuss bipolardisorderandcomorbiduseofillicitsubstances AT martinschaefer bipolardisorderandcomorbiduseofillicitsubstances AT christophborn bipolardisorderandcomorbiduseofillicitsubstances AT heinzgrunze bipolardisorderandcomorbiduseofillicitsubstances
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Bipolar Disorder and Comorbid Use of Illicit Substances

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