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ma_bd_sud_final_version.pdf (1.11 MB)

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2024-10

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cc-by-nc-nd (C) Sociedad Española de Psiquiatría y Salud Mental
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/218736

Meta-analysis of the effects of adjuvant drugs in co-occurring bipolar and substance use disorder

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https://doi.org/10.1016/j.rpsm.2023.01.005

Resum

Background: Individuals with bipolar disorder (BD) often have co-occurring substance use disorders (SUDs), which substantially impoverish the course of illness. Despite the importance of this dual diagnosis, the evidence of the efficacy and safety of adjuvant treatments is mostly unknown. Objective: To perform a meta-analysis to evaluate the efficacy and safety of adjuvant drugs in patients with co-occurring BD and SUD. Methods: We searched PubMed, Scopus, and Web of Knowledge until 30th April 2022 for randomized clinical trials (RCT) evaluating the efficacy and safety of adjuvant drugs compared to placebo in patients with a dual diagnosis of BD and SUD. We meta-analyzed the effect of adjuvant drugs on general outcomes (illness severity, mania, depression, anxiety, abstinence, substance craving, substance use, gamma-GT, adherence, and adverse events) and used the results to objectively assess the quality of the evidence according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. For completeness, we also report the specific effects of specific adjuvant drugs in patients with specific substance disorders. Results: We included 15 RCT studies (9 alcohol, 3 cocaine, 2 nicotine, and 1 cannabis) comprising 628 patients allocated to treatment and 622 to placebo. There was low-quality evidence that adjuvant drugs may reduce illness severity (g = -0.25, 95% CI: -0.44, -0.06), and very-low quality evidence that they may decrease substance use (g = -0.23, 95% CI: -0.44, -0.02) and increase substance abstinence (g = 0.21,95% CI: 0.04, 0.38). Discussion: There is low-quality evidence that adjuvant drugs may help reduce illness severity, probably via facilitating abstinence and lower substance use. However, the evidence is weak; thus, these results should be considered cautiously until better evidence exists. (c) 2023 SEP y SEPB. Published by Elsevier Espa & ntilde;a, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Matèries

Alcohol, Trastorn bipolar

Matèries (anglès)

Alcohol, Bipolar disorder

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Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

Citació

RADUA, Joaquim, FORTEA, Lydia, GOIKOLEA ALBERDI, José manuel, ZORRILLA, Inaki, BERNARDO ARROYO, Miquel, ARROJO, Manuel, CUNILL, Ruth, CASTELLS, Xavi, BECONA, Elisardo, LOPEZ DURAN, Ana, TORRENS, Marta, TIRADO MUNOZ, Judit, FONSECA, Francina, ARRANZ, Belen, GARRIGA, Marina, SÁIZ, Pilar a, FLÓREZ, Gerardo, SAN, Luis, GONZALEZ PINTO, Ana. Meta-analysis of the effects of adjuvant drugs in co-occurring bipolar and substance use disorder. _Revista De Psiquiatria Y Salud Mental_. 2024. Vol. 17, núm. 4, pàgs. 239-250. [consulta: 10 de gener de 2026]. ISSN: 1888-9891. [Disponible a: https://hdl.handle.net/2445/218736]

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