Bipolar and Related Disorders
Pharmacological management of bipolar disorder with atypical antipsychotics (such as quetiapine, olanzapine, risperidone) or lithium has a strong evidence base.
Bipolar disorder and comorbid substance use disorder (including alcohol) may be assisted by integrated group therapy at least for substance use outcomes based on the work of one research group including two randomised controlled trials (RCTs).
A small number of poor quality trials (RCTs & open label trials) in people with comorbid bipolar and substance use disorders support the likely efficacy of atypical antipsychotics (such as quetiapine, olanzapine, risperidone) or lithium in reducing bipolar symptoms with no consistent evidence for an effect of substance use (including alcohol).
| Chapter |
Recommendation |
Grade of recommendation |
| 21.27 |
Integrative group therapy for comorbid bipolar and substance use disorder is likely to provide better substance use outcomes than intervention focused on substance use alone for people with this comorbidity |
B |
| 21.28 |
Atypical antipsychotics (such as quetiapine, olanzapine, risperidone) appear to reduce symptoms of bipolar disorder in people with comorbid bipolar and substance use disorder but there is little evidence of benefit for substance use including alcohol |
C |