People who suffer from bipolar affective disorder are also more commonly affl icted with chronic somatic conditions. Higher mortality is observed in this population compared to healthy subjects. In patients with bipolar disorder a more frequent occurrence of such conditions as hypertension, hyperlipidemia, hepatitis C, type II diabetes and coronary heart disease is noticed. High somatic comorbidity is due to a number of factors, depending on the patient, the disease itself and the treatment used. The presence of a somatic disease restricts the use of antidepressants, mood stabilizers and antipsychotics. Based on the research available, the author discusses some restrictions regarding the use of classic and second-generation mood stabilizers and antidepressants in the most common chronic diseases, such as cardiovascular disease, diabetes and other metabolic disorders, liver failure, kidney, epilepsy and glaucoma. The awareness of these limitations allows us to incorporate them in the treatment of bipolar disorder in somatically ill patients, which is a safeguard against therapeutic failure.