Despite the high levels of comorbidity, there is not much evidence to guide treatment of patients with bipolar disorder who also experience alcohol-use disorder.5 It is important to consider treatment compliance when managing patients with bipolar disorder and comorbid alcohol abuse, and this may guide treatment options, such as lithium (which patients are sometimes instructed not to mix with alcohol), valproate, or psychosocial interventions.5
References:
1. Hunt GE, Malhi GS, Cleary M, et al. Prevalence of comorbid bipolar and substance use disorders in clinical settings, 1990–2015: systematic review and meta-analysis. J Affect Disord 2016; 206: 331–349.
2. Hunt GE, Malhi GS, Cleary M, et al. Comorbidity of bipolar and substance use disorders in national surveys of general populations, 1990–2015: systematic review and meta-analysis. J Affect Disord 2016; 206: 321–330.
3. Di Florio A, Craddock N, van den Bree M. Alcohol misuse in bipolar disorder. A systematic review and meta-analysis of comorbidity rates. Eur Psychiatry 2014; 29 (3): 117–124.
4. Grunze H, Schaefer M, Scherk H, et al. Comorbid bipolar and alcohol use disorder – a therapeutic challenge. Front Psychiatry 2021; 12: 660432.
5. Sonne SC, Brady KT. Bipolar disorder and alcoholism. Alcohol Res Health 2002; 26 (2): 103–108.