The Carlat Psychiatry Podcast When Bipolar and ADHD Overlap: Treatment 1
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Nov 25, 2024 Discover the delicate balance needed when treating ADHD in individuals with bipolar disorder. The discussion includes the potential risks of stimulant medications and their neurotoxic effects, along with effective non-stimulant alternatives. Insights into various medications like modafinils, alpha agonists, and lithium reveal their impact on mood stabilization. Learn about the importance of careful treatment strategies that prioritize mental well-being while effectively managing symptoms.
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Cognitive Issues and ADHD in Bipolar
- Cognitive issues in bipolar disorder have multiple potential causes, including mood instability and ADHD.
- True ADHD comorbidity starts before age 12, persists independent of mood, and may improve with age.
Stimulant Choice and Dosage in Bipolar
- In bipolar, use methylphenidate over amphetamines for ADHD treatment due to lower psychosis and mania risk.
- Keep methylphenidate doses below 45mg, and amphetamine doses below 30mg.
Non-Stimulant Options for Bipolar and ADHD
- For bipolar with ADHD, prioritize non-stimulants like clonidine, guanfacine, or modafinil.
- These offer a double benefit by addressing both ADHD and bipolar symptoms like sleep and irritability.