TREATMENT OF COMORBID AFFECTIVE AND SUBSTANCE USE DISORDERS - THERAPEUTIC POTENTIAL OF ANTICONVULSANTS

The authors examine the use of anticonvulsants/mood stabilizers To tre at patients with substance use disorders. Although there is high comor bidity of bipolar and substance use disorders, there has been little r esearch oil the use of these medications to treat bipolar disorders in patients who also have a substance use disorders. However, symptoms o f bipolar disorders, such as irritability and mood lability, may be di fficult to distinguish from The effects of acute and chronic substance use; therefore, reliable diagnostic methods will need to be developed Further a new, hypothesized syndrome, Explosive Mood Disorder, is des cribed that may be distinct from the bipolar spectrum. It is character ized by childhood onset of temper out bursts and irritable mood that p ersists into adolescence and adulthood, is connected to marijuana use, and responds to divalproex sodium, The authors review studies of prev alence, comorbidity, family history, longitudinal course, and placebo- controlled trials of anticonvulsant medications to evaluate the validi ty and treatment implications of this proposed entity.