Substance abuse by patients with bipolar disorder does not appear to slow their recovery, but it may indicate that patients have a more rapid cycling form of the disease, according to a study funded by the National Institute of Mental Health, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism.
A team of scientists studied 3750 patients with bipolar 1 or 2 disorder enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD), a multicenter prospective observational trial conducted from 1999 to 2005 (Ostacher MJ et al. Am J Psychiatry. 2010;167:289-297). The researchers hypothesized that patients with a current or past comorbid substance use disorder would experience a longer period between a major depressive episode and recovery than would those without such comorbidity. Although they did not find an association with past or current substance abuse with a longer time to recovery, they did find that patients with past or current substance abuse were more likely to experience rapid cycling from depression to manic, hypomanic, or mixed states.
Kuehn BM. Bipolar Disorder and Addiction. JAMA. 2010;303(20):2022. doi:https://doi.org/10.1001/jama.2010.645
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