Posted by jrbecker on April 24, 2003, at 16:57:06
In reply to Re: Bipolar and ADHD (HELP!), posted by Stacey fu on April 24, 2003, at 2:22:35
An Open Trial of Bupropion for the Treatment of Adults with Attention Deficit Hyperactivity Disorder and Bipolar Disorder
Timothy E. Wilens, Jefferson B. Prince, Thomas Spencer, Stephanie L. Van Patten, Robert Doyle, Kristine Girard, Paul Hammerness, Sarah Goldman, Sarah Brown and Joseph Biederman
Accepted 8/26/2002Abstract
Background: Despite the increasing recognition of comorbid Attention Deficit Hyperactivity Disorder (ADHD) and Bipolar Disorder (BPD) in adults, there are no prospective trials of pharmacological agents to treat ADHD in these patients. Given the efficacy of bupropion for ADHD in adults, as well as its use in the management of bipolar depression, we studied the tolerability and efficacy of sustained-release bupropion in adults with ADHD plus BPD.Methods: This was an open, prospective, six-week trial of bupropion SR (up to 200 mg BID) in adults with DSM IV ADHD plus historical BPD I (10%) or BPD II (90%). Adults receiving adjunct anti-manic agents (mood stabilizers and antipsychotics) at baseline were included in the study. We used standardized psychiatric instruments for diagnosis and outcome. Efficacy was based primarily on Clinical Global Impression (CGI) for ADHD and the ADHD symptom checklist.
Results: Of 36 patients entered (75% male, mean age 34 years), 30 patients completed the protocol (83%). At endpoint (LOCF), compared to baseline, treatment with bupropion SR resulted in significant reductions in the ADHD symptom checklist (-55%, z=5.63, p<0.001) and CGI severity of ADHD (-40%, z=6.285, p<0.001). Bupropion was associated with reductions in ratings of mania and depression.
Conclusions: The results from this open study of adults with ADHD plus BPD suggest that sustained-release bupropion may be effective in treating ADHD in the context of a lifetime diagnosis of BPD without significant activation of mania. Further controlled trials are warranted.
poster:jrbecker
thread:221068
URL: http://www.dr-bob.org/babble/20030423/msgs/222063.html