Pharmacological treatment of comorbid posttraumatic stress disorder in patients with bipolar disorder
Introduction The lifetime prevalence of comorbid posttraumatic stress disorder (PTSD) in patients with bipolar disorder (BD) is approximately 20%. Guidelines for BD give adequate pharmacological treatment options when there is a ‘pure’ bipolar disorder but lack of treatment options when there is a...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2022-06-01
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| Series: | European Psychiatry |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933822010306/type/journal_article |
| _version_ | 1797617249794654208 |
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| author | S. Hendriks P. Goossens |
| author_facet | S. Hendriks P. Goossens |
| author_sort | S. Hendriks |
| collection | DOAJ |
| description |
Introduction
The lifetime prevalence of comorbid posttraumatic stress disorder (PTSD) in patients with bipolar disorder (BD) is approximately 20%. Guidelines for BD give adequate pharmacological treatment options when there is a ‘pure’ bipolar disorder but lack of treatment options when there is a comorbid disorder present.
Objectives
The present study aimed to review the pharmacological treatment options for comorbid PTSD in patients with BD.
Methods
Literature research was conducted via PubMed, Embase and the Cochrane Library. Search terms included ‘bipolar disorder’, ‘posttraumatic stress disorder’, ‘PTSD’, ‘pharmacotherapy’ and ‘treatment’. Relevant studies were reviewed.
Results
No randomized controlled trials have been conducted in patients with bipolar disorder and comorbid PTSD. Most studies included open-label studies and case-reports. No convincing scientific evidence for pharmacological treatment of comorbid PTSD in patients with BD was found. Selective serotonin reuptake inhibitors (SSRIs) are effective in the treatment of PTSD. However, SSRIs or other antidepressants are complicated due to potential induction of a manic episode or promote rapid cycling. Nevertheless, it is important to treat the bipolar patient with a mood stabilizer first before antidepressants are prescribed.
Conclusions
The findings of this study show that there is no convincing scientific evidence for the pharmacological treatment of comorbid PTSD in patients with bipolar disorder. Therefore, psychotherapy is preferable. When psychotherapy is not effective, pharmacotherapy can be considered. However, randomized controlled trials are needed to obtain scientific evidence for pharmacological treatment options.
Disclosure
No significant relationships.
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| first_indexed | 2024-03-11T07:53:07Z |
| format | Article |
| id | doaj.art-fa9c05abea8449a68d289937fced03ae |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:53:07Z |
| publishDate | 2022-06-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-fa9c05abea8449a68d289937fced03ae2023-11-17T05:06:25ZengCambridge University PressEuropean Psychiatry0924-93381778-35852022-06-0165S406S40610.1192/j.eurpsy.2022.1030Pharmacological treatment of comorbid posttraumatic stress disorder in patients with bipolar disorderS. Hendriks0P. Goossens1Dimence Group Center for Mental Health Care, Specialized Center Bipolar Disorders, Deventer, NetherlandsDimence Group Center for Mental Health Care, Specialized Center Bipolar Disorders, Deventer, Netherlands Introduction The lifetime prevalence of comorbid posttraumatic stress disorder (PTSD) in patients with bipolar disorder (BD) is approximately 20%. Guidelines for BD give adequate pharmacological treatment options when there is a ‘pure’ bipolar disorder but lack of treatment options when there is a comorbid disorder present. Objectives The present study aimed to review the pharmacological treatment options for comorbid PTSD in patients with BD. Methods Literature research was conducted via PubMed, Embase and the Cochrane Library. Search terms included ‘bipolar disorder’, ‘posttraumatic stress disorder’, ‘PTSD’, ‘pharmacotherapy’ and ‘treatment’. Relevant studies were reviewed. Results No randomized controlled trials have been conducted in patients with bipolar disorder and comorbid PTSD. Most studies included open-label studies and case-reports. No convincing scientific evidence for pharmacological treatment of comorbid PTSD in patients with BD was found. Selective serotonin reuptake inhibitors (SSRIs) are effective in the treatment of PTSD. However, SSRIs or other antidepressants are complicated due to potential induction of a manic episode or promote rapid cycling. Nevertheless, it is important to treat the bipolar patient with a mood stabilizer first before antidepressants are prescribed. Conclusions The findings of this study show that there is no convincing scientific evidence for the pharmacological treatment of comorbid PTSD in patients with bipolar disorder. Therefore, psychotherapy is preferable. When psychotherapy is not effective, pharmacotherapy can be considered. However, randomized controlled trials are needed to obtain scientific evidence for pharmacological treatment options. Disclosure No significant relationships. https://www.cambridge.org/core/product/identifier/S0924933822010306/type/journal_articleTreatmentposttraumatic stress disorderPharmacotherapybipolar disorder |
| spellingShingle | S. Hendriks P. Goossens Pharmacological treatment of comorbid posttraumatic stress disorder in patients with bipolar disorder European Psychiatry Treatment posttraumatic stress disorder Pharmacotherapy bipolar disorder |
| title | Pharmacological treatment of comorbid posttraumatic stress disorder in patients with bipolar disorder |
| title_full | Pharmacological treatment of comorbid posttraumatic stress disorder in patients with bipolar disorder |
| title_fullStr | Pharmacological treatment of comorbid posttraumatic stress disorder in patients with bipolar disorder |
| title_full_unstemmed | Pharmacological treatment of comorbid posttraumatic stress disorder in patients with bipolar disorder |
| title_short | Pharmacological treatment of comorbid posttraumatic stress disorder in patients with bipolar disorder |
| title_sort | pharmacological treatment of comorbid posttraumatic stress disorder in patients with bipolar disorder |
| topic | Treatment posttraumatic stress disorder Pharmacotherapy bipolar disorder |
| url | https://www.cambridge.org/core/product/identifier/S0924933822010306/type/journal_article |
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