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Stimulants for treating bipolar disorder: pro and con
1From Newcastle University, Institute of Neuroscience, Academic Psychiatry Campus of Aging and Vitality, Wolfson Research Building, Westgate Road, Newcastle upon Tyne NE4 5PL, United Kingdom.
Abstract:
The role of stimulants for treating severe depression remains controversial, especially when it comes to bipolar depression. Potential benefits have to be weighed against risks, including addictive potential and treatment-emergent mania. But not all stimulants are the same. Modafinil and its R-enantiomer armodafinil seem to have positive augmentation effects when coupled with standard treatment of bipolar depression, while also having a relative low risk of addiction and manic switches. A recent hypothesis derived from the observation of hypovigilance in manic patients postulates that modafinil may also have a beneficial effect in reducing manic behaviors. Further controlled studies are needed to clarify the benefits and risks of stimulants, both in bipolar depression and mania.
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