Magazine article Clinical Psychiatry News

Stimulant Useful for Comorbid ADHD, Bipolar

Magazine article Clinical Psychiatry News

Stimulant Useful for Comorbid ADHD, Bipolar

Article excerpt

BOSTON -- Children and adolescents being treated for bipolar disorder and comorbid attention-deficit/hyperactivity disorder may benefit from the short-term use of adjunctive methylphenidate, a study has shown.

The findings add to the growing body of evidence supporting the concomitant treatment of both conditions. Using methylphenidate to treat patients with bipolar disorder has been the subject of controversy in light of concerns that the use of stimulant drugs in bipolar patients could exacerbate or trigger manic symptoms.

In fact, according to lead author Dr. Robert L. Findling of University Hospitals Case Medical Center, Cleveland, the addition of methylphenidate to monotherapy with either lithium or divalproex sodium (DVPX) or to combination therapy with both drugs "did not cause a destabilization of improved mood symptoms" in the 4-week, double-blind, placebo-controlled trial.

To examine the short-term efficacy of adjunctive methylphenidate in this patient population, Dr. Findling and his colleagues enrolled 20 young people aged 5-17 years who met DSM-IV criteria for bipolar disorder and ADHD. At the time of the investigation, all of the study participants were receiving a stable dose of at least one thymoleptic agent, and continued to have clinically significant symptoms of ADHD while euthymic.

As per study protocol, all of the patients received 1 week each of placebo, 5 mg of methylphenidate twice daily, 10 mg of methylphenidate twice daily, and 15 mg of methylphenidate twice daily using a crossover design, and were randomly assigned to receive one of six possible dosing orders. …

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