Atypical Antipsychotics May Be Useful in Bipolar Disorder With Addiction

By David Douglas

 

NEW YORK (Reuters Health) Sept 26 - The atypical antipsychotics quetiapine and risperidone appear to be of certain limited benefit in patients with bipolar disorder and concurrent cocaine or methamphetamine dependence.

"In some patients," lead investigator Dr. Vicki A. Nejtek said in an interview with Reuters Health, "practitioners can probably expect to see reductions in mania, depression, and drug cravings with less side effects using lower doses of quetiapine or risperidone than the recommended pharmaceutical guidelines."

"Despite mood and drug use improvements," she added, "clinicians should not expect to see sudden drug abstinence, as we found drug use in both medication groups remained dynamic."

Dr. Nejtek of the University of North Texas Health Science Center, Fort Worth, and colleagues studied patients who were randomized to escalating doses of quetiapine or risperidone.

Only 14 of the original 94 patients who received study medication completed all 20 weeks of treatment, the team reports in the August issue of the Journal of Clinical Psychiatry. Results were analyzed for 80 patients who were present at baseline and had attended at least 1 weekly follow-up study visit.

Both quetiapine and risperidone significantly improved manic and depressive symptoms and reduced drug cravings compared to baseline. There were no significant differences between the agents in this regard.

The drugs were well tolerated, but Dr. Nejtek concluded that "the medication response we observed suggests that while mood disorders and addictions may co-occur, they appear to have different neurobiological mechanisms that require disease-specific treatments."