%0 Journal Article
%T Special considerations in the treatment of patients with bipolar disorder and medical co-morbidities
%A Kimberly D McLaren
%A Lauren B Marangell
%J Annals of General Psychiatry
%D 2004
%I BioMed Central
%R 10.1186/1475-2832-3-7
%X A review of the literature was conducted and papers addressing this topic were selected by the authors.Common medical comorbidities and treatment-emergent illnesses, including obesity, diabetes mellitus, dyslipidemia, cardiac disease, hepatic disease, renal disease, pulmonary disease and cancer are reviewed with respect to concomitant use of mood stabilizers. Guidance to clinicians regarding effective monitoring and treatment is offered.Mood-stabilizing medications are necessary in treating patients with bipolar disorder and often must be used in the face of medical illness. Their safe use is possible, but requires increased vigilance in monitoring for treatment-emergent illnesses and effects on comorbid medical illness.Patients with bipolar disorder are among the most challenging to treat pharmacologically, especially in the presence of medical comorbidity. Although the rates of medical comorbidity are high in patients with bipolar disorder (20¨C80%), medical illnesses are frequently underdiagnosed and inadequately treated in psychiatric patients. For example, Cradock-O'Leary and colleagues reviewed centralized Veterans Affairs data and examined the use of medical services by 175,653 veterans during fiscal year 2000 [1]. They identified 3,694 veterans with a primary diagnosis of bipolar disorder and compared the care that these veterans received to that of all veterans. Among all veterans with diabetes and hypertension, those with a comorbid diagnosis of bipolar disorder (as well as those with diagnoses of anxiety disorder, schizophrenia, post-traumatic stress disorder, or a substance use disorder) were less likely to have more than one medical visit in one year. This is especially concerning given that veterans are afforded medical and psychiatric treatment within one comprehensive health care system, seemingly making care more accessible. Patients with bipolar disorder in the general population are likely receiving even less medical care. The significance of this
%K bipolar disorder
%K medical illness
%K obesity
%K diabetes mellitus
%K dyslipidemia
%K cardiac disease
%K hepatic disease
%K renal disease
%K pulmonary disease
%K cancer
%K mood stabilizers
%K anticonvulsants
%K atypical antipsychotics
%U http://www.annals-general-psychiatry.com/content/3/1/7