PMID- 23457180
OWN - NLM
STAT- MEDLINE
DCOM- 20130812
LR  - 20211021
IS  - 1472-1465 (Electronic)
IS  - 0007-1250 (Print)
IS  - 0007-1250 (Linking)
VI  - 202
IP  - 3
DP  - 2013 Mar
TI  - Bipolar disorder and substance misuse: pathological and therapeutic implications 
      of their comorbidity and cross-sensitisation.
PG  - 172-6
LID - 10.1192/bjp.bp.112.116855 [doi]
AB  - BACKGROUND: Bipolar disorder has a high co-occurrence with substance use 
      disorders, but the pathophysiological mechanisms have not been adequately 
      explored. AIMS: To review the role of stress in the onset and recurrence of 
      affective episodes and substance misuse. METHOD: We review the mechanisms 
      involved in sensitisation (increased responsivity) to recurrence of stressors, 
      mood episodes and cocaine use. RESULTS: Evidence suggests that intermittent 
      stressors, mood episodes and bouts of cocaine use not only show sensitisation to 
      themselves, but cross-sensitisation to the others contributing to illness 
      progression. Converseley, an understanding of the common mechanisms of 
      sensitisation (such as regionally selective alterations in brain derived 
      neurotrophic factor (BDNF) and hyperactivity of striatally based habit memories), 
      could also result in single therapies (such as N-acetylcysteine) having positive 
      effects in all three domains. CONCLUSIONS: These interacting sensitisation 
      processes suggest the importance of early intervention in attempting to prevent 
      increasingly severe manifestations of bipolar illness and substance misuse 
      progression.
FAU - Post, Robert M
AU  - Post RM
AD  - MD, Head, Bipolar Collaborative Network, 5415 W. Cedar Lane, Suite 201-B, 
      Bethesda, MD 20814, USA. robert.post@speakeasy.net
FAU - Kalivas, Peter
AU  - Kalivas P
LA  - eng
GR  - P50 DA015369/DA/NIDA NIH HHS/United States
GR  - R01 DA003906/DA/NIDA NIH HHS/United States
GR  - R01 DA012513/DA/NIDA NIH HHS/United States
PT  - Journal Article
PT  - Review
PL  - England
TA  - Br J Psychiatry
JT  - The British journal of psychiatry : the journal of mental science
JID - 0342367
RN  - 0 (Brain-Derived Neurotrophic Factor)
RN  - 0 (Dopamine Uptake Inhibitors)
RN  - 0 (Free Radical Scavengers)
RN  - I5Y540LHVR (Cocaine)
RN  - WYQ7N0BPYC (Acetylcysteine)
SB  - IM
MH  - Acetylcysteine/pharmacology/therapeutic use
MH  - Age of Onset
MH  - Animals
MH  - Basal Ganglia/drug effects
MH  - Behavior, Addictive/drug therapy
MH  - Bipolar Disorder/*epidemiology/metabolism/psychology
MH  - Brain-Derived Neurotrophic Factor/metabolism
MH  - Central Nervous System Sensitization/physiology
MH  - Cocaine/adverse effects
MH  - Cocaine-Related Disorders/*epidemiology/metabolism/psychology
MH  - Comorbidity
MH  - Diagnosis, Dual (Psychiatry)
MH  - Disease Models, Animal
MH  - Disease Progression
MH  - Dopamine Uptake Inhibitors/adverse effects
MH  - Epigenomics
MH  - Free Radical Scavengers/pharmacology/therapeutic use
MH  - Humans
MH  - Recurrence
MH  - Stress, Psychological/epidemiology/metabolism/psychology
PMC - PMC4340700
MID - NIHMS665768
COIS- Dr. Robert Post reports no financial conflict of interest pertinent to this 
      manuscript. Dr. Peter Kalivas reports no competing interests.
EDAT- 2013/03/05 06:00
MHDA- 2013/08/13 06:00
PMCR- 2015/02/25
CRDT- 2013/03/05 06:00
PHST- 2013/03/05 06:00 [entrez]
PHST- 2013/03/05 06:00 [pubmed]
PHST- 2013/08/13 06:00 [medline]
PHST- 2015/02/25 00:00 [pmc-release]
AID - S0007125000273789 [pii]
AID - 10.1192/bjp.bp.112.116855 [doi]
PST - ppublish
SO  - Br J Psychiatry. 2013 Mar;202(3):172-6. doi: 10.1192/bjp.bp.112.116855.