Do atypical antipsychotics effectively treat co-occurring bipolar disorder and stimulant dependence? A randomized, double-blind trial

Vicki Allene Nejtek, Matthew Avila, Li Ann Chen, Tanya Zielinski, Marija Djokovic, Alan Podawiltz, Kathryn Kaiser, Sejong Bae, A. John Rush

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

Objectives: The primary objective was to compare the efficacy and tolerability of quetiapine and risperidone in the treatment of mood symptoms, drug cravings, and drug use in outpatients with concurrent DSM-IV-defined bipolar I or II disorder and cocaine or methamphetamine dependence. Method: Men and women of all ethnic origins, 20 to 50 years of age, were eligible to participate. Persons were excluded if they were inpatients, met DSM-IV criteria for substance-induced mood disorder, had any other substance dependence, were euthymic or suicidal, had any life-threatening illnesses, or were currently receiving antipsychotic medications. Duration of the trial was 20 weeks. Study participants attended weekly visits and were evaluated for mood symptoms, drug cravings, drug use, and medication side effects. Treatment outcomes were analyzed using linear mixed models. Fixed-effects terms for medication group, study week, and group-by-study-week were included in the models. The study was conducted between October 2002 and November 2006. Results: Of 124 consenting outpatients, an evaluable sample of 80 patients who attended baseline and at least 1 follow-up study visit was formed. The mean ± SD exit dose for quetiapine was 303.6 ± 151.9 mg/day and 3.1 ± 1.2 mg/day for risperidone. Both quetiapine (N = 42) and risperidone (N = 38) significantly improved manic and depressive symptoms and reduced drug cravings (p < .0005) compared to baseline. Decreased drug cravings were related to less frequent drug use (p = .03). The 2 medications did not significantly differ in their effects on mood symptoms, drug craving, or drug use. Conclusions: Relative to baseline mood and drug-craving status, both quetiapine and risperidone were associated with manic, mixed, and depressive symptom improvement and reduced drug cravings. Both medications were well tolerated. The interpretation of these results is limited by the absence of a placebo control. Trial Registration: clinicaltrials.gov Identifier: NCT00227123.

Original languageEnglish
Pages (from-to)1257-1266
Number of pages10
JournalJournal of Clinical Psychiatry
Volume69
Issue number8
DOIs
StatePublished - 1 Jan 2008

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Bipolar Disorder
Antipsychotic Agents
Pharmaceutical Preparations
Risperidone
Diagnostic and Statistical Manual of Mental Disorders
Outpatients
Depression
Methamphetamine
Craving
Mood Disorders
Cocaine
Substance-Related Disorders
Inpatients
Linear Models
Placebos
Quetiapine Fumarate

Cite this

Nejtek, Vicki Allene ; Avila, Matthew ; Chen, Li Ann ; Zielinski, Tanya ; Djokovic, Marija ; Podawiltz, Alan ; Kaiser, Kathryn ; Bae, Sejong ; Rush, A. John. / Do atypical antipsychotics effectively treat co-occurring bipolar disorder and stimulant dependence? A randomized, double-blind trial. In: Journal of Clinical Psychiatry. 2008 ; Vol. 69, No. 8. pp. 1257-1266.
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Do atypical antipsychotics effectively treat co-occurring bipolar disorder and stimulant dependence? A randomized, double-blind trial. / Nejtek, Vicki Allene; Avila, Matthew; Chen, Li Ann; Zielinski, Tanya; Djokovic, Marija; Podawiltz, Alan; Kaiser, Kathryn; Bae, Sejong; Rush, A. John.

In: Journal of Clinical Psychiatry, Vol. 69, No. 8, 01.01.2008, p. 1257-1266.

Research output: Contribution to journalArticle

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T1 - Do atypical antipsychotics effectively treat co-occurring bipolar disorder and stimulant dependence? A randomized, double-blind trial

AU - Nejtek, Vicki Allene

AU - Avila, Matthew

AU - Chen, Li Ann

AU - Zielinski, Tanya

AU - Djokovic, Marija

AU - Podawiltz, Alan

AU - Kaiser, Kathryn

AU - Bae, Sejong

AU - Rush, A. John

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