Psychologists report that more than 21 percent of adult bipolar disorder patients are also diagnosed as having ADHD. It is not unusual for the symptoms of both disorders to overlap, which makes differentiating between the two illnesses difficult. When confirmed that a patient suffers from both disorders, determining the appropriate medication regimen can present a challenge. As people respond to pharmaceuticals differently, finding the right combination of drugs and at the right dosages to effectively treat both syndromes often requires trial and error. There are a variety of options from which practitioners commonly choose.
As the various selections of stimulants commonly used to treat ADHD can often trigger manic episodes in patients having bipolar disorder, physicians more frequently opt to alleviate symptoms using a class of medications known as non-stimulants. Atomoxetine belongs to this group of drugs. The pharmaceutical and similar formulations inhibit the neurotransmitter norepinephrine, which plays a major role in producing excitability. The medication is used primarily to increase attention-span while controlling hyperactive behavior or poor impulse control. However, in patients suffering from manic episodes, the drug can exacerbate the problem. When taken with a mood stabilizer, the medication is usually safe and effective for bipolar patients. Non-stimulants are also beneficial as the effects last a full 24 hours.
More commonly known as Wellbutrin, the medication was formulated to treat depression and has been proven effective in treating the depressive symptoms in bipolar patients. Physicians recommend combining bupropion with mood stabilizers because compared to other antidepressants, the medication is less likely to trigger manic episodes. A six-week study performed on 30 adults diagnosed with both disorders revealed that 82 percent of the trial participants experienced a reduction in both depression and ADHD symptoms without enduring the side effect of mania.
All psychiatrists are not convinced that patients might have co-existing ADHD and bipolar disorders. Some believe that the symptoms of hyperactivity, restlessness, excessive verbalization and frequent mood changes are merely signs of bipolar disorder. Regardless of whether a patient has bipolar disorder singly or in conjunction with ADHD, the mood stabilizer lithium has long been the go to formula for effectively managing manic symptoms. Carbamazepine or valproic acid are other options. As certain ADHD medications can worsen manic symptoms and practitioners might be unsure whether a patient may be suffering from both mental health illnesses, physicians often initially focus treatment on alleviating the symptoms associated with bipolar disorder. Once a patient's bipolar symptoms are managed properly, treatment may then gradually include medications that successfully treat ADHD.