The Risks of Stimulants in Bipolar Patients

Stimulants are typically the first line treatment for ADHD, but their use in patients with bipolar disorder is fraught with risks. The potential for inducing mania and psychosis is significant, with studies showing that taking stimulants without an antimanic mood stabilizer raises the risk of mania seven-fold. Although some patients can be managed with mood stabilizers, about one in seven still experience worsening mood symptoms when using stimulants. Among stimulants, amphetamines are particularly concerning, as they are more likely to provoke psychosis compared to methylphenidate, necessitating careful consideration before prescribing.