
- Vol 38, Issue 1
- Volume 38
- Issue 01
ADHD in Patients With Bipolar Disorder: Genetics, Diagnosis, and Treatment
Although clinicians and patients may wish otherwise, the comorbidity of ADHD and bipolar disorder needs to be considered.
BIPOLAR UPDATE
Recent study results revealed that children with a diagnosis of attention-deficit/hyperactivity disorder (ADHD) had a
The comorbidity of ADHD and BD may involve overlapping genetics. In Sweden, 13,532 twin pairs (aged 9 to 12 years) were
The bottom line of these data is that it is important to take the time to diagnose bipolar disorder accurately in patients with a history of ADHD or who are presenting with current ADHD. Mood-stabilizing medications such as lithium will usually be indicated for the bipolar condition.
Stimulant treatment of ADHD when there is comorbid BD has been controversial. However, an important 2016 study by
In summary, it is critically important to carefully evaluate whether patients with ADHD also have BD. If you miss the bipolar diagnosis and treat the ADHD with a stimulant, the potential for harm (ie, induction of mania) is considerable. However, if the bipolar disorder is under control with a mood stabilizer, the use of a stimulant (at least methylphenidate) need not be avoided. Indeed, it may be quite helpful.
Dr Osser is associate professor of psychiatry, Harvard Medical School, and co-lead psychiatrist, US Department of Veterans Affairs, National Telemental Health Center, Bipolar Disorders Telehealth Program, Brockton, MA. He is a member of the Psychiatric TimesTM Editorial Board. The author reports no conflicts of interest concerning the subject matter of this article.
This article was originally posted ahead of print on October 30, 2020 under the title ADHD in Bipolar Patients: Genetics, Diagnosis, and Treatment, and has since been updated. -Ed
References
1. Meier SM, Pavlova B, Dalsgaard S, et al.
2. Lan W-H, Bai Y-M, Hsu J-W, et al.
3. Hosang GM, Lichtenstein P, Ronald A, Lundström, Taylor MJ.
4. Viktorin A, Rydén E, Thase ME, et al.
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