Alcohol use may not worsen bipolar disorder outcomes
MedWire News: Neither moderate nor excessive alcohol consumption has a negative effect on illness course or outcome in patients with bipolar disorder, study results suggest.
The researchers were particularly surprised by the lack of effect among excessive drinkers, but note that their study group showed good medication adherence and were older on average than participants in previous studies.
Jan van Zaane (University Medical Centre Amsterdam, The Netherlands) and colleagues initiated a prospective study of 137 bipolar disorder patients who registered their mood symptoms and actual alcohol consumption every day for 12 months.
After data collection, patients were assigned to three groups based on average number of alcohol units consumed per week (based on the Dutch standard of 10g pure alcohol per unit): non/incidental use, 0-2 units per week; moderate use, 3-21 units (men), 3-14 units (women); excessive use, 22 or more units (men), 15 or more units (women).
Men were considered to have a heavy drinking day if they consumed 5 or more units per day, and women 4 or more units per day.
After a year there were no significant differences between the groups in terms of number of days ill, severity of depression, mania and overall bipolar illness, and Global Assessment of Functioning scale.
Because the number of drinks per week in excessive drinkers had no upper limit, outcomes were analysed for the top 10% of heavy-drinking-day patients and those with an AUD, but still no effect was found.
Discussing the findings, van Zaane and colleagues note that medication adherence in the study cohort was high at around 90%, while history of drug use was only 25% and current drug use just 5%. In addition, patients in the current study tended to be older with more established illness than those in previous studies, with an average duration of 22 years.
"Our findings suggest that recommendations to patients with bipolar disorder to refrain from alcohol completely are not applicable to all patients with bipolar disorder," they comment in the Journal of Clinical Psychiatry.
"Nevertheless, we support recommendations from others that patients with a comorbid AUD should receive integrated treatment… especially to bipolar disorder patients in the early course of their illness."
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By Andrew Czyzewski