Self-Medication, Bipolar Disorders, and Stimulant Dependence

Sir: In the August 2008 issue of the Journal, Nejtek et
al. present findings that both quetiapine and risperidone
produced improvement in manic, mixed, and depressive symptoms.
In turn, symptom reduction was associated with reduced
drug cravings in patients with co-occurring bipolar and stimulant
dependence disorders, albeit not affecting drug use. These
are important findings in that (1) there is an extraordinarily
high incidence of co-occurrence of substance abuse in general
associated with bipolar disorders and, in particular, a high cooccurrence
of stimulant abuse; and (2) there are few if any specific
effective psychopharmacologic treatments for stimulant dependence.