title: Bupropion as an add-on therapy in depressed bipolar disorder type I patients with comorbid cocaine dependence.
abstract: OBJECTIVE
  The treatment of bipolar disorder type I (BD-I) with a comorbid cocaine dependence disorder (CDD) is a challenge in current psychiatric practice. Drugs with proven efficacy in manic/mixed episodes, such as atypical antipsychotics and mood stabilizers, sometimes do not prevent depressive relapses; on the other hand, the use of antidepressants during acute depressive episodes may increase the risk of a manic switch. The aim of the present study was to investigate the short-term efficacy of bupropion augmentation in acutely depressed BD-I patients with co-occurring CDD.
  
  
  METHODS
  Twelve depressed BD-I patients, with a comorbid CDD, treated with valproate 1000 to 1500 mg/d and aripiprazole 10 mg/d, were randomly assigned to receive bupropion 150 mg/d as an open-label add-on therapy (n = 5) or to continue their previous treatment (n = 7).
  
  
  RESULTS
  After 4 weeks of observation, patients receiving add-on therapy with bupropion have improved in terms of Hamilton Depression Rating Scale scores and Drug Abuse Screening Test scores, with respect to those of the comparison group, whereas no significant increase of Young Mania Rating Scale scores over time was observed.
  
  
  CONCLUSIONS
  Our preliminary findings suggest that combining bupropion with mood stabilizers and atypical antipsychotics may be a good therapeutic option in short-term treatment of depressed BD-I patients with comorbid CDD.
authors.affiliation: *Department of Neuroscience and Imaging, Chair of Psychiatry, "G. d'Annunzio" University of Chieti; and †Department of Mental Health, National Health Trust, Chieti; and ‡Psychiatric Rehabilitation Clinic "Villa Jolanda," Jesi, Italy.
authors.forename: Gianna
authors.initials: G
authors.lastname: Sepede
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di lorio
authors.forename: Matteo
authors.initials: M
authors.lastname: Lupi
authors.forename: Fabiola
authors.initials: F
authors.lastname: Sarchione
authors.forename: Tiziano
authors.initials: T
authors.lastname: Acciavatti
authors.forename: Federica
authors.initials: F
authors.lastname: Fiori
authors.forename: Rita
authors.initials: R
authors.lastname: Santacroce
authors.forename: Giovanni
authors.initials: G
authors.lastname: Martinotti
authors.forename: Francesco
authors.initials: F
authors.lastname: Gambi
authors.forename: Massimo
authors.initials: M
authors.lastname: Di Giannantonio
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use; D000068180:Aripiprazole; D001714:Bipolar Disorder / Q000150:complications* / Q000188:drug therapy*; D016642:Bupropion / Q000627:therapeutic use*; D019970:Cocaine-Related Disorders / Q000150:complications*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use; D011569:Psychiatric Status Rating Scales; D015363:Quinolones / Q000627:therapeutic use; D014635:Valproic Acid; D055815:Young Adult
chemical_list: D018687:Antidepressive Agents, Second-Generation; D014150:Antipsychotic Agents; D010879:Piperazines; D015363:Quinolones; D016642:Bupropion; D014635:Valproic Acid; D000068180:Aripiprazole