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Use of Stimulants in Bipolar Disorder

  • Bipolar Disorders (R Hirschfeld, Section Editor)
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Abstract

Several international guidelines indicate stimulants, including methylphenidate (MPH), amphetamines and derivatives, modafinil, and armodafinil among the second-third-line choices for bipolar depression. Efficacy of stimulants has been also reported for the management of residual depressive symptoms such as fatigue and sleepiness and for the management of affective, cognitive, and behavioral symptoms in children and adult bipolar patients with comorbid ADHD. Few case reports show positive results with MPH in the treatment of resistant mania. Finally, MPH might be an option in some bipolar forms observed in psychiatric presentations of frontotemporal dementia and traumatic brain injury. In spite of these preliminary observations, the use of stimulants in bipolar patients is still controversial. Potential of misuse and abuse and mood destabilization with induction of (hypo)manic switches, mixed states, and rapid cycling are the concerns most frequently reported. Our aims are to summarize available literature on this topic and discuss practical management implications.

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Authors and Affiliations

  1. Department of Experimental and Clinic Medicine, Section of Psychiatry, University of Pisa, Via Roma 67, 56100, Pisa, Italy

    Giulio Perugi

  2. Institute of Behavioural Science “G.De Lisio”, Pisa, Italy

    Giulio Perugi

  3. Dipartimento di Neuroscienze, Psicologia, Area del Farmaco e Salute del Bambino (NEUROFARBA), University of Florence, Florence, Italy

    Giulia Vannucchi

  4. CREA, Research and Clinical Centre, San Sebastiano Foundation, Florence, Italy

    Giulia Vannucchi

  5. Psychiatric Service, General Hospital of Bressanone, Brixen, Italy

    Fulvio Bedani & Ettore Favaretto

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  1. Giulio Perugi
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Correspondence to Giulio Perugi.

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Perugi, G., Vannucchi, G., Bedani, F. et al. Use of Stimulants in Bipolar Disorder. Curr Psychiatry Rep 19, 7 (2017). https://doi.org/10.1007/s11920-017-0758-x

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