Substance Abuse and Bipolar Affective Disorder

Sonne, Susan C.; Brady, Kathleen T.; Morton, William A.

doi:10.1097/00005053-199406000-00007

Cited by 196 publications

(116 citation statements)

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“…74,[77][78][79] Others have noted an association between ADs and mixed as opposed to euphoric mania. 80,81 BD patients with high levels of anxiety symptoms experience more substance abuse and chronic suicidal ideation and these patients are less responsive to treatment with lithium, 77,82,83 and may have an earlier onset of mood illness. 72,74 Rates of comorbidity are another aspect of illness that has appeared to differentiate BDII from BDI.…”

Section: Psychiatric Comorbiditymentioning

confidence: 99%

The phenotypes of bipolar disorder: relevance for genetic investigations

2005

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The search for susceptibility genes for bipolar disorder (BD) depends on appropriate definitions of the phenotype. In this paper, we review data on diagnosis and clinical features of BD that could be used in genetic studies to better characterize patients or to define homogeneous subgroups. Clinical symptoms, long-term course, comorbid conditions, and response to prophylactic treatment may define groups associated with more or less specific loci. One such group is characterized by symptoms of psychosis and linkage to 13q and 22q. A second group includes mainly bipolar II patients with comorbid panic disorder, rapid mood switching, and evidence of chromosome 18 linkage. A third group comprises typical BD with an episodic course and favourable response to lithium prophylaxis. Reproducibility of cognitive deficits across studies raises the possibility of using cognitive profiles as endophenotypes of BD, with deficits in verbal explicit memory and executive function commonly reported. Brain imaging provides a more ambiguous data set consistent with heterogeneity of the illness. Keywords: bipolar disorder; genetics; endophenotype; neurocognitive function; brain imaging Bipolar disorder (BD) has a genetic basis with heritability of at least 80%. 1 A number of studies have attempted to map the susceptibility loci giving evidence of linkage in multiple genomic regions. In particular, findings in 4p, 4q, 8q, 10p, 12q24, 13q, 18p, 18q, 21q, and 22q have been supported by more than one study. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] However, these studies have not identified any specific genes, and a recent metaanalysis of available genome scans showed no regions with a conclusive evidence of linkage. 20 The relatively slow progress of gene-mapping efforts is often explained by the 'complex' nature of the illness and of the genotype-phenotype relation. The complexity most likely includes heterogeneity, interactions of multiple loci, incomplete penetrance, as well as phenotypes resulting from environmental effects-either alone or in interaction with the genetic predisposition. The goal of psychiatric genetic research is identification of (heritable) variations in DNA sequence or function that influence behaviour or give rise to mental illness. By definition, in complex (multifactorial) traits, this link is not unique and specific. That is, a particular change in gene sequence does not necessarily lead to a specific behaviour, and similar behaviours (symptoms) may be due to distinct (sets of) genes. Moreover, we must consider the possibility that the path between the genotype and behaviour is not unidirectional. Emerging examples point not only to general effects of environment, for instance stress, on behaviour, but also to specific behaviours influencing gene function that can be transmitted onto the next generation. 21 No single method is considered clearly superior in identifying susceptibility genes for complex traits such as BD. Most researchers agree that a combination of strategies is most lik...

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Section: Psychiatric Comorbiditymentioning

confidence: 99%

The phenotypes of bipolar disorder: relevance for genetic investigations

2005

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“…Bipolar disorder patients with substanceuse disorders are over three times more likely than patients without substance-use disorders to have comorbid lifetime anxiety disorders (Sonne et al, 1994), and they are more likely to have comorbid Axis II disorders (Kay et al 1999). While studies have found a link between substance use and increased comorbidity, the relevance of the type of substance abuse to the type of Axis I comorbidity in bipolar disorder has not been well studied.…”

Section: Introductionmentioning

confidence: 99%

Comorbid disorders in patients with bipolar disorder and concomitant substance dependence

Mitchell

Brown

Rush

2007

Journal of Affective Disorders

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Objective-Substance dependence is common in bipolar disorder and is associated with an increase in Axis I and II comorbidity. Little research has compareed the relative rates of comorbidity among bipolar patients with dependence on different substances. Methods-TheMini International Neuropsychiatric Interview (M.I.N.I.) was used to assess 166 outpatients involved in one of three clinical trials of medicatiosn for bipolar disorder and substance dependence. Patients had concurrent alcohol dependence, cocaine dependence, or both conditions.Results-Generalized anxiety disorder and current depressed mood were significantly more common in bipolar patients with alcohol dependence than bipolar patients with cocaine dependence. Those with cocaine dependence had significantly higher rates of post-traumatic stress disorder and anti-social personality disorder and were more likely to present in a mixed mood state than patients dependent on alcohol. Cocaine dependent patients were more likely than alcohol dependent patients to have bipolar I relative to bipolar II.Limitations-This is a retrospective, cross-sectional data analysis using the M.I.N.I. for diagnosis.Conclusions-Cocaine dependence and alcohol dependence were associated with different clinical features and comorbid disorders in bipolar patients. The results may help confirm the validity of integrative models of mood, behavioral, anxiety, and personality disorders. Further studies on the causal relationship between substance dependence and concurrent and lifetime Axis I disorders for patients with bipolar disorders are indicated.

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“…al co hol and mef lo qu i ne-indu ced ma ni a). 8,9 In our ca se, the pa ti ent de ve lo ped ma nic symptoms fol lo wing a short co ur se of sul buti a mi ne ad mi nis tra ti on at the pro per the ra pe u tic do sa ge of 400 mg/day. An overdose of sul bu ti a mine (2000 mg/day) that trig ge red ma nic at tack in a pa ti ent with a pre vi o us bi po lar his tory was re ported be fo re.…”

Section: Discussionmentioning

confidence: 67%

Manic Attack Possibly Triggered by Sulbutiamine: Case Report

Bulut¹,

Virit²,

Selek³

et al. 2011

Turkiye Klinikleri J Med Sci

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ulbutiamine is a hydrophobic molecule that easily crosses the bloodbrain barrier and increases thiamine and thiamine phosphate esters in the brain.1,2 It does not have psycho-stimulant properties and is currently used for the treatment of somatic and psychic inhibitions. Sulbutiamine is not an antidepressant. It helps with psycho-motor inhibition during episodes of major depressive disorder and facilitates rehabilitation of patients in their social, professional, and family life functioning.3 Moreover, it improves performance in behavioural models of inhibition (induced by an aversive situation) such as "learned helplessness" and "forced swimming A AB BS S T TR RA AC CT T Sul bu ti a mi ne is a pre cur sor of thi a mi ne that cros ses the blo od-bra in bar ri er. The modu la tory ef fects on both do pa mi ner gic and glu ta ma ter gic trans mis si ons wit hin the pref ron tal cortex co uld play a pi vo tal ro le in the the ra pe u tic ac ti on of sul bu ti a mi ne. Sul bu ti a mi ne is cur rently used for the tre at ment of fa ti gu e, exhaustion and ast he ni a in physi cal and psychi at ric di sor ders; ho wever, it does not have any psycho-sti mu lant pro per ti es. Whi le sul bu ti a mi ne has no an ti-dep res si ve ef fect, it ex hi bits se ve ral psychot ro pic ef fects such as a dec re a se in psycho-be ha vi o u ral in hi bi ti on oc cur ring in ma jor dep res si ve di sor der. In this re port, we des cri be a pos sib le ca se of sul bu ti a mine-trig ge red ma nic at tack in a pa ti ent with ma jor dep res si ve di sor der, who la ter de ve lo ped bi po lar I di sor der with spon ta ne o us ma nic epi so des. To our know led ge, this is the first pos sib le ca se of sulbutiamine-triggered ma nic at tack at the pro per the ra pe u tic do sa ge of sul bu ti a mi ne in a ma jor dep res si ve pa ti ent.K Ke ey y W Wo or rd ds s: : Sul bu ti a mi ne; bi po lar di sor der Ö ÖZ ZE ET T Sul bu ti a min, ti a mi nin kan-be yin ba ri ye ri ni ge çen bir ön cü lü dür. Et ki me ka niz ma sın da prefron tal kor teks te do pa mi ner jik ve glu ta ma ter jik ile ti ler üze rin de dü zen le yi ci et ki le ri, muh te me len önem li rol al mak ta dır. Sul bu ti a min gü nü müz de fi zik sel ve psi ki yat rik has ta lık lar da ki yor gun luk, bit kin lik ve hal siz li ğin te da vi sin de kul la nıl mak ta dır. Bu na kar şın, hiç bir psi ko-uya rı cı et ki si bu lunma mak ta dır. Sul bu ti a min an ti dep re san et ki ye sa hip de ğil dir, an cak ma jör dep re sif bo zuk luk ta meyda na ge len gün lük ak ti vi te le re kar şı il gi kay bı gi bi psi ko so yal dav ra nış lar da azal ma gi bi çe şit li psi kot ro fik et ki ler ser gi le mek te dir. Bu ça lış ma da, ma jör dep re sif bo zuk lu ğu bu lu nan bir has ta da muh te me len sul bu ti a min ta ra fın dan te tik le nen ma nik atak ol gu su nu ta nım la dık. Bil di ği miz ka darıy la, bu va ka, uy gun te da vi do zun da kul la nıl ma sı na rağ men sul bu ti a mi nin ma jör dep re sif bir hasta da te tik le di ği ilk ma nik atak ol gu su dur.A An na ah h t ta ar r K Ke e...

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Substance Abuse and Bipolar Affective Disorder

Cited by 196 publications

References 0 publications

The phenotypes of bipolar disorder: relevance for genetic investigations

The phenotypes of bipolar disorder: relevance for genetic investigations

Comorbid disorders in patients with bipolar disorder and concomitant substance dependence

Manic Attack Possibly Triggered by Sulbutiamine: Case Report

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