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The impact of psychiatric co-morbidity in the treatment of bipolar disorder: focus on co-occurring attention deficit hyperactivity disorder and eating disorders 

The impact of psychiatric co-morbidity in the treatment of bipolar disorder: focus on co-occurring attention deficit hyperactivity disorder and eating disorders
Chapter:
The impact of psychiatric co-morbidity in the treatment of bipolar disorder: focus on co-occurring attention deficit hyperactivity disorder and eating disorders
Author(s):

Anna I. Guerdjikova

, Paul E. Keck Jr

, and Susan L. McElroy

DOI:
10.1093/med/9780198748625.003.0018
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date: 20 August 2019

Bipolar disorder (BD) commonly co-occurs with attention deficit hyperactivity disorder (ADHD) and eating disorders (EDs) in adolescents and in adults. The aim of this chapter is to summarize the available data regarding prevalence, clinical presentation, and psychological and pharmacological treatment of such complicated cases. Results of randomized controlled and open-label trials and case reports are reviewed. The main therapeutic goal when treating BD co-morbid with ADHD or ED is selecting a treatment strategy effective in the management of both syndromes, or at the minimum, selecting one that treats one syndrome without exacerbating the other. Controlled data are scarce. Various classes of medications, including stimulants, atomoxetine, bupropion, and wakefulness-provoking agents, might hold promise as adjunctive medication in improving ADHD symptoms in euthymic BD patients. The specificities of the ED, namely the predominance of undereating or overeating, need to be considered when selecting agents in the treatment of BD co-morbid with EDs.

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