2013 issue 3–4


Volume 29, issue 3–4

Review article

Pharmacological treatment of bipolar disorder comorbid with alcohol dependence

Daria Zielińska1, Kaja Wieczorek2, Marcin Siwek3, Barbara Bętkowska-Korpała4, Dominika Dudek3
1. Szpital Specjalistyczny im. dr. J. Babińskiego w Krakowie
2. Instytut Psychologii Stosowanej Uniwersytetu Jagiellońskiego w Krakowie
3. Zakład Zaburzeń Afektywnych Katedry Psychiatrii Uniwersytetu Jagiellońskiego Collegium Medicum w Krakowie; Instytut Farmakologii Polskiej Akademii Nauk, Kraków
4. Zakład Psychologii Lekarskiej Katedry Psychiatrii Uniwersytetu Jagiellońskiego Collegium Medicum w Krakowie
Farmakoterapia w Psychiatrii i Neurologii, 2013, 3–4, 177–185
Keywords: bipolar disorder, alcohol dependence, psychopharmacology, comorbidity


Comorbidity of alcohol dependence and bipolar disorder (BD) poses a diagnostic and therapeutic challenge. A correct diagnosis is diffi cult to arrive at because of the similarity of symptoms occurring in both illnesses. A diagnostic mistake can lead to an incorrect pharmacological treatment and, in consequence, to BD deterioration. However, proper diagnosis requires a specifi c therapy, which is complicated not only because the symptoms are complex, but also because of the difficulties of cooperating with patients, who may tend to mix medication with alcohol. The main aim of this article is to present the results of the studies conducted in order to evaluate the effectiveness of different kinds of drugs used in this group of patients. The medication recommended as the first line treatment is valproic acid. Some of the described drugs proved to be effective in both of these illnesses but only in the open-label studies (i.e. topiramate, arypiprazole), whereas the drugs usually used in alcohol dependence are recommended to reduce drinking and consequently the possible complications. Lately, attention has been paid to baclofen and nalmefene, which have shown some efficiency but data concerning the dual-diagnosis patients is still scarce.