Comorbid substance use disorder in bipolar disorder: A hard rock to roll on the treatment road

Altınbaş, Kürşat

doi:10.14744/dajpns.2021.00128

Cited by 1 publication

(1 citation statement)

References 16 publications

(37 reference statements)

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“…A recent review explored the use of gabapentin and pregabalin in the treatment of patients with BD, indicating a potential role of these medications in the management of SUD comorbidity ( 71 ). Similarly, oxcarbazepine has been proposed as an alternative treatment for SUD during pregnancy ( 72 ), but with scarce evidence for the treatment of SUD in comorbidity with BD ( 73 ). The increased prevalence of polypharmacy, particularly benzodiazepines and other drugs, in patients suffering from BD and polySUD should be framed as an attempt to reduce abstinence, treat residual symptoms as sleep or anxiety derived from potential subsyndromal psychotic symptoms, or recognize the need for better mood stabilization.…”

Section: Discussionmentioning

confidence: 99%

Bipolar Disorder and Polysubstance Use Disorder: Sociodemographic and Clinical Correlates

Aguglia

Natale²,

Fusar-Poli³

et al. 2022

Front. Psychiatry

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IntroductionPatients with bipolar disorder (BD) often show comorbidity with substance use disorder (SUD) with a negative impact on clinical course, prognosis, and functioning. The role of polysubstance use disorder (polySUD) is understudied. The aim of the present paper is to evaluate the sociodemographic and clinical characteristics associated with BD and comorbid SUD, focusing on polySUD, in order to phenotype this specific group of patients and implement adequate treatment and prevention strategies.MethodsA cross-sectional study was conducted involving 556 patients with a primary diagnosis of BD (376 without SUD, 101 with SUD, and 79 with polySUD). A semi-structured interview was administered to collect sociodemographic variables, clinical characteristics, and pharmacological treatment. ANOVA and chi-square tests were used to compare the three groups. Significantly different variables were then inserted in multivariate logistic regression.ResultsPatients affected by BD and polySUD were younger, and more frequently males and single, than patients with SUD or without SUD. Indeed, the prevalence of patients affected by BD and polySUD living in residential facilities was higher than in the other groups. Moreover, earlier age at onset, higher prevalence of psychotic and residual symptoms, involuntary hospitalization, and a family history of psychiatric disorders were associated with polySUD in patients suffering from BD. Lastly, patients with BD and polySUD were more likely to take four or more medications, particularly benzodiazepines and other drugs. At the multinomial regression, younger age, male gender, early age at onset, psychotic and residual symptoms, positive family history of psychiatric disorders, and use of benzodiazepines remained significantly associated with polySUD in patients with BD.ConclusionOur findings show a specific profile of patients with BD and polySUD. It is important to conduct research on this topic in order to adopt specific therapeutic strategies, minimize the use of polypharmacy, and aim at full remission and mood stabilization.

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Section: Discussionmentioning

confidence: 99%