How Methylphenidate Might Be Safe in Patients with Both Bipolar Disorder and Attention Deficit/Hyperactivity Disorder

Although attention-deficit/hyperactivity disorder (ADHD) has been reported in up to 20% of patients with bipolar disorder, many clinicians are reluctant to treat these patients with stimulants for fear of inducing switches to mania. Research into this topic has been limited. Using data from Swedish national registries, investigators identified patients over age 18 diagnosed with bipolar disorder who received a prescription for initiating methylphenidate between 2005 and 2013 after being presumably stimulant-free for ≥9 months. Mood stabilizers (lithium, anticonvulsants, antipsychotics) were prescribed to 1103 individuals, whereas 718 received no mood stabilizers. Mania was examined in periods on and off methylphenidate.

Mood stabilizer treat…