Q: Can I Take Stimulants If I Have Comorbid ADHD and Bipolar Disorder?
In people who have comorbid ADHD and bipolar disorder, treating both conditions leads to the best outcome, but deciding whether to use stimulants to treat ADHD in people with bipolar can be complicated.
The prevailing concern has been that stimulants can de-stabilize a person with bipolar and, while this is a valid concern for people who are not on optimized mood stabilizers, recent research suggests the risk may be low for bipolar patients whose symptoms are well-managed with medication.The study that’s frequently cited to justify the use of stimulants in stabilized bipolar disorder is the Swedish National Registry, which involved 2,300 patients over the course of 8 years.1 These were patients who were admitted into the hospital for mania or a change in their mood-stabilizing medication.
They were studied from zero to three months, and then from three to six months. This is important because if you add in even a short-acting medication like a stimulant, the effect of that medication on the stability of the patient may not become evident right away.The study found that, for people with bipolar and ADHD, when methylphenidate was added in:[Self-Test: Bipolar Disorder in Adults]The Canadian Network for Mood and Anxiety Treatment and the International Society for Bipolar Disorder put the same recommendations in their 2018 guidelines, saying that stimulants may be used for ADHD in stable youth with bipolar taking optimal doses of anti-manic medication.
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