title: Sulbutiamine, an 'innocent' over the counter drug, interferes with therapeutic outcome of bipolar disorder.
abstract: A case of a patient with bipolar disorder with a history of hospitalizations and addiction to sulbutiamine is presented. Sulbutiamine is a precursor of thiamine that crosses the blood-brain barrier and is widely available without prescription in most countries or over the internet. Because of this patient's need to consume ever increasing quantities of sulbutiamine, his psychiatric care was severely compromised through him defaulting appointments and frequent changes of psychiatrists. This paper reviews the current scientific knowledge about sulbutiamine, and some of the information and claims available on the web about its use and potential. It is argued that doctors need to be aware of the potential misuse of medication available over the counter or on the internet and its potential harmful influence.
authors.affiliation: Department of General Hospital Psychiatry, Athens University Medical School, Attikon Hospital, Greece.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Douzenis
authors.forename: Ioannis
authors.initials: I
authors.lastname: Michopoulos
authors.forename: Lefteris
authors.initials: L
authors.lastname: Lykouras
mesh_terms: D000328:Adult; D018692:Antimanic Agents / Q000008:administration & dosage / Q000009:adverse effects; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D004305:Dose-Response Relationship, Drug; D004347:Drug Interactions; D006760:Hospitalization; D006801:Humans; D008297:Male; D004366:Nonprescription Drugs / Q000008:administration & dosage / Q000009:adverse effects*; D010359:Patient Readmission; D012651:Self Medication; D019966:Substance-Related Disorders / Q000150:complications* / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation; D013831:Thiamine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D016312:Treatment Refusal / Q000523:psychology*
chemical_list: D018692:Antimanic Agents; D014150:Antipsychotic Agents; D004366:Nonprescription Drugs; C031331:sulbutiamine; D013831:Thiamine