TY - JOUR
T1 - An open trial of bupropion for the treatment of adults with attention-deficit/hyperactivity disorder and bipolar disorder
AU - Wilens, Timothy E.
AU - Prince, Jefferson B.
AU - Spencer, Thomas
AU - Van Patten, Stephanie L.
AU - Doyle, Robert
AU - Girard, Kristine
AU - Hammerness, Paul
AU - Goldman, Sarah
AU - Brown, Sarah
AU - Biederman, Joseph
N1 - Funding Information:
This project was funded by GlaxoSmithKline, Inc. and National Institutes of Health (NIH) RO1 DA12945 (TEW).
PY - 2003/7/1
Y1 - 2003/7/1
N2 - Background: Despite the increasing recognition of comorbid attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder (BPD) in adults, there are no prospective trials of pharmacological agents to treat ADHD in these patients. Given the efficacy of bupropion for ADHD in adults, as well as its use in the management of bipolar depression, we studied the tolerability and efficacy of sustained-release (SR) bupropion in adults with ADHD plus BPD. Methods: This was an open, prospective, 6-week trial of bupropion SR (up to 200 mg b.i.d.) in adults with DSM-IV ADHD plus historical bipolar I disorder (BPD I) (10%) or bipolar II disorder (BPD II) (90%). Adults receiving adjunct antimanic agents (mood stabilizers and antipsychotics) at baseline were included in the study. We used standardized psychiatric instruments for diagnosis and outcome. Efficacy was based primarily on the Clinical Global Impression Scale (CGI) for ADHD and the ADHD symptom checklist. Results: Of 36 patients entered (75% male, mean age 34 years), 30 patients (83%) completed the protocol. At end point (last observation carried forward [LOCF]) compared to baseline, treatment with bupropion SR resulted in significant reductions in the ADHD symptom checklist (-55%, z = 5.63, p < .001) and CGI severity of ADHD (-40%, z = 6.285, p < .001). Bupropion was associated with reductions in ratings of mania and depression. Conclusions: The results from this open study of adults with ADHD plus BPD suggest that sustained-release bupropion may be effective in treating ADHD in the context of a lifetime diagnosis of BPD, without significant activation of mania. Further controlled trials are warranted.
AB - Background: Despite the increasing recognition of comorbid attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder (BPD) in adults, there are no prospective trials of pharmacological agents to treat ADHD in these patients. Given the efficacy of bupropion for ADHD in adults, as well as its use in the management of bipolar depression, we studied the tolerability and efficacy of sustained-release (SR) bupropion in adults with ADHD plus BPD. Methods: This was an open, prospective, 6-week trial of bupropion SR (up to 200 mg b.i.d.) in adults with DSM-IV ADHD plus historical bipolar I disorder (BPD I) (10%) or bipolar II disorder (BPD II) (90%). Adults receiving adjunct antimanic agents (mood stabilizers and antipsychotics) at baseline were included in the study. We used standardized psychiatric instruments for diagnosis and outcome. Efficacy was based primarily on the Clinical Global Impression Scale (CGI) for ADHD and the ADHD symptom checklist. Results: Of 36 patients entered (75% male, mean age 34 years), 30 patients (83%) completed the protocol. At end point (last observation carried forward [LOCF]) compared to baseline, treatment with bupropion SR resulted in significant reductions in the ADHD symptom checklist (-55%, z = 5.63, p < .001) and CGI severity of ADHD (-40%, z = 6.285, p < .001). Bupropion was associated with reductions in ratings of mania and depression. Conclusions: The results from this open study of adults with ADHD plus BPD suggest that sustained-release bupropion may be effective in treating ADHD in the context of a lifetime diagnosis of BPD, without significant activation of mania. Further controlled trials are warranted.
KW - ADHD
KW - Adults
KW - Bipolar disorder
KW - Pharmacotherapy
UR - http://www.scopus.com/inward/record.url?scp=0038771154&partnerID=8YFLogxK
U2 - 10.1016/S0006-3223(02)01664-5
DO - 10.1016/S0006-3223(02)01664-5
M3 - Article
C2 - 12842303
AN - SCOPUS:0038771154
SN - 0006-3223
VL - 54
SP - 9
EP - 16
JO - Biological Psychiatry
JF - Biological Psychiatry
IS - 1
ER -