How to Treat ADHD in Bipolar Disorder

Topics: ADHD | Alpha Agonists | Amphetamines | ArModafinil | Atomoxetine | Attention Deficit Hyperactivity Disorder | Bipolar Disorder | Bipolar II | Comorbidity | Guanfacine | methylphenidate | Modafinil | Nuvigil | Pharmacology | Provigil | Psychopharmacology | Psychopharmacology Tips | stimulant | Stimulants

Patients with bipolar disorder often present with cognitive complaints. Our October 2021 issue laid out a diagnostic plan for these symptoms, and in this article, I’ll cover some treatment approaches for patients with a DSM-based ADHD-bipolar comorbidity (ie, the ADHD symptoms began in childhood and persist after the mood episodes have stabilized).

A Closer Look at Alpha-2 Agonists for ADHD

Topics: ADHD | Alpha Agonists

The alpha-2 agonists guanfacine ER (Intuniv) and clonidine ER (Kapvay) were approved for ADHD in 2010–2011, but three things have held back their use: They are less effective than stimulants (effect size of 0.5 vs. 0.8) They are only approved in children and adolescents Cost Recently, the ER versions went generic and the first major trial in a

Beta Blockers and Depression: The Controversy Revisited

Topics: Alpha Agonists | Beta-blockers | Guanfacine | Medical Comorbidities | Research Update

Review of: Agustini B et al, J Hum Hypertens 2020;34(11):787–794 Study Type: Cross-sectional Antihypertensives are among the world’s most widely prescribed drugs, but many of them impact pathways associated with depression. Beta blockers have long been believed to cause depression, but most of the studies suggesting this were carried out decades a

Guanfacine ER for Adults With ADHD?

Topics: ADHD | Alpha Agonists | attention | Attention Deficit Hyperactivity Disorder | Guanfacine | Pharmacology | Psychopharmacology | Research Update

Review of: Iwanami A et al, J Clin Psychiatry 2020;81(3):19m12979 Study type: Randomized, double-blind, placebo-controlled trial Stimulants are rapid, safe, and effective first-line treatments for many adults with ADHD. However, there are inevitably patients for whom stimulants are not indicated or tolerated—those with arrhythmias or stimulant use d