[Bipolar Disorder and substance abuse: an explosive mixture?]

Comorbidity summary between Bipolar Disorder and Substance use disorders is very frequent. But, often, is misdiagnosed, sometimes with dangerous consequences. The addict bipolars may have more mixed states and rapid cycling. Their evolution is worse than in non comorbid bipolars and often they are refractory to lithium. But they may be responsive to anticonvulsants, perhaps because of their antikindling effect. Both pathologias may influence and boost reciprocably. When bipolar illness starts first, the clinical pattern is worse.