Using medication to treat ADHD and bipolar doesn’t have to be complicated. Both disorders contain abnormalities in the signaling of norepinephrine and dopamine. However, isn’t there a chance that ADHD stimulant medication could throw a client into mania if they have both? Well question no more!
Due to the overlap in symptoms for ADHD and bipolar (looking at you impulsivity and difficulty concentrating), it can be hard to initially discern if a client is experiencing mania or symptoms of ADHD. For this reason, it is important to focus on thorough assessment to rule out certain symptoms and their effects on functioning.
Some also recommend initial medication efforts focus on mood stabilization. If symptoms persist continually past days or weeks, a diagnosis of ADHD might be in order.
Several studies address the impact of ADHD medication use with co-morbid bipolar disorder. In one study, no record of medication-induced mania occurred with methylphenidate (aka Ritalin or Concerta). Similar results occur with atomoxetine and amphetamine salts. Talk about a relief for bipolar clients who may be struggling in the executive functioning department!
While examples of increased symptoms of mania have occurred, adjusting medication dosage or type appears to alleviate the risk. For those of us with clients exhibiting life-long symptoms of ADHD, this may be a sign for evaluation referral.
Medication management is a significant part of managing symptoms of bipolar disorders or ADHD. And, while concerns about providing stimulants to someone with a history of mania are valid, stimulant medication appears to be a relatively safe part of treating co-morbid ADHD.
For additional info on stimulants and other psychotropic medications, our therapist resources medication page has more.
