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Treating Two Conditions
"I take medication for bipolar disorder. Now my psychiatrist thinks I also have ADHD—and wants me to start taking a stimulant, too. Is that safe?"
There are no formal contraindications between stimulants and any of the dozen or so medications commonly prescribed for bipolar disorder. However, that does not mean that adding a stimulant to your current drug regimen is necessarily safe for you. Certain medical conditions, including high blood pressure, can make it risky to take a stimulant no matter what other medications you currently take. To be on the safe side, discuss your medical history with your psychiatrist before taking the stimulant.
In addition, make sure that your bipolar disorder is stabilized before you add a stimulant. If not, the stimulant might trigger mania. Finally, you indicate that your doctor "thinks" that you have ADHD. Make sure he clarifies the diagnosis, as ADHD and bipolar disorder can cause many of the same symptoms, including restlessness, impulsivity, and inattention. Doctors sometimes confuse the two conditions.
Larry Silver, M.D., is clinical professor of psychiatry at Georgetown Medical Center in Washington, D.C. and director of training in child and adolescent psychiatry at Georgetown University School of Medicine. He is a former acting director and deputy director of the National Institute of Mental Health, as well as the author of Dr. Larry Silver's Advice to Parents on AD/HD and The Misunderstood Child: Understanding and Coping with Your Child's Learning Disabilities.