Stimulants for treating bipolar disorder: pro and con.
The role of stimulants for treating severe depression remains controversial, especially when it comes to bipolar depression. Potential benefits have to be weighed against risks, including addictive potential and treatment-emergent mania. But not all stimulants are the same. Modafinil and its R-enantiomer armodafinil seem to have positive augmentation effects when coupled with standard treatment of bipolar depression, while also having a relative low risk of addiction and manic switches. A recent hypothesis derived from the observation of hypovigilance in manic patients postulates that modafinil may also have a beneficial effect in reducing manic behaviors. Further controlled studies are needed to clarify the benefits and risks of stimulants, both in bipolar depression and mania.
From Newcastle University, Institute of Neuroscience, Academic Psychiatry Campus of Aging and Vitality, Wolfson Research Building, Westgate Road, Newcastle upon Tyne NE4 5PL, United Kingdom.
Heinz
H
Grunze
D000662:Amphetamines / Q000627:therapeutic use; D001559:Benzhydryl Compounds / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D006801:Humans; D000077408:Modafinil
D000662:Amphetamines; D001559:Benzhydryl Compounds; D000697:Central Nervous System Stimulants; D000077408:Modafinil