PURPOSE OF REVIEW: Attention-deficit/hyperactivity disorder (ADHD) and mania show broad symptom overlap, and high comorbidity exists between ADHD and bipolar disorder. This raises the question concerning common neurobiological pathomechanisms and concerning common treatments. RECENT FINDINGS: On genetic, biochemical, electrophysiological, brain morphological and neuropsychological levels, the commonalities of ADHD and mania and the commonalities between ADHD and bipolar disorder (independent of manic state) are outlined. An intriguing finding is that both ADHD and mania are characterized by an unstable wakefulness regulation assessed by EEG measures of vigilance, by ratings of sleepiness and by deficits in sustained attention tasks. In both mania and ADHD, this unstable wakefulness regulation is supposed to be a central pathogenetic factor leading to attention deficits and inducing the hyperactive, impulsive and sensation-seeking behavior as an autoregulatory attempt to stabilize wakefulness by increasing external stimulation. Evidence is accumulating to suggest that psychostimulants do not have a high risk of triggering or aggravating mania, but might even be a treatment option in acute mania. SUMMARY: ADHD and mania share many symptoms and several pathogenetic aspects. The common belief that stimulants are contraindicated in mania has been challenged, and controlled trials to study the possible antimanic effects of vigilance-stabilizing drugs such as stimulants are justified and necessary.
PURPOSE OF REVIEW: Attention-deficit/hyperactivity disorder (ADHD) and mania show broad symptom overlap, and high comorbidity exists between ADHD and bipolar disorder. This raises the question concerning common neurobiological pathomechanisms and concerning common treatments. RECENT FINDINGS: On genetic, biochemical, electrophysiological, brain morphological and neuropsychological levels, the commonalities of ADHD and mania and the commonalities between ADHD and bipolar disorder (independent of manic state) are outlined. An intriguing finding is that both ADHD and mania are characterized by an unstable wakefulness regulation assessed by EEG measures of vigilance, by ratings of sleepiness and by deficits in sustained attention tasks. In both mania and ADHD, this unstable wakefulness regulation is supposed to be a central pathogenetic factor leading to attention deficits and inducing the hyperactive, impulsive and sensation-seeking behavior as an autoregulatory attempt to stabilize wakefulness by increasing external stimulation. Evidence is accumulating to suggest that psychostimulants do not have a high risk of triggering or aggravating mania, but might even be a treatment option in acute mania. SUMMARY:ADHD and mania share many symptoms and several pathogenetic aspects. The common belief that stimulants are contraindicated in mania has been challenged, and controlled trials to study the possible antimanic effects of vigilance-stabilizing drugs such as stimulants are justified and necessary.
Authors: Ronald C Kessler; Johan Ormel; Maria Petukhova; Katie A McLaughlin; Jennifer Greif Green; Leo J Russo; Dan J Stein; Alan M Zaslavsky; Sergio Aguilar-Gaxiola; Jordi Alonso; Laura Andrade; Corina Benjet; Giovanni de Girolamo; Ron de Graaf; Koen Demyttenaere; John Fayyad; Josep Maria Haro; Chi yi Hu; Aimee Karam; Sing Lee; Jean-Pierre Lepine; Herbert Matchsinger; Constanta Mihaescu-Pintia; Jose Posada-Villa; Rajesh Sagar; T Bedirhan Ustün Journal: Arch Gen Psychiatry Date: 2011-01
Authors: Angelina R Sutin; Roy G Cutler; Simonetta Camandola; Manuela Uda; Neil H Feldman; Francesco Cucca; Alan B Zonderman; Mark P Mattson; Luigi Ferrucci; David Schlessinger; Antonio Terracciano Journal: Biol Psychiatry Date: 2013-04-10 Impact factor: 13.382
Authors: Michael Kluge; Ulrich Hegerl; Christian Sander; Jens Dietzel; Roland Mergl; Istvan Bitter; Koen Demyttenaere; Ricardo Gusmão; Ana Gonzalez-Pinto; Victor Perez-Sola; Eduard Vieta; Georg Juckel; Ulrich S Zimmermann; Michael Bauer; Pascal Sienaert; Sónia Quintão; Marc-Andreas Edel; Csilla Bolyos; Jose Luis Ayuso-Mateos; Pilar López-García Journal: BMC Psychiatry Date: 2013-02-27 Impact factor: 3.630