The DOI matches its Crossref record; 171 of the 172 references it cites were found in a registry or an index.
The Canadian Network for Mood and Anxiety Treatments (Canmat) Task Force Recommendations for the Management of Patients with Mood Disorders and Comorbid Attention-Deficit/Hyperactivity Disorder
Abstract
Background: Patients with bipolar disorder (BD) and major depressive disorder (MDD) experience adult attention-deficit/hyperactivity disorder (ADHD) at rates substantially greater than the general population. Nonetheless, ADHD frequently goes untreated in this population. Methods: We reviewed the literature regarding the management of adult ADHD in patients with mood disorders. Because a limited number of studies have been conducted in adults, our treatment recommendations also are partly informed by research in children and adolescents with BD+ADHD or MDD+ADHD, adults with ADHD, and our clinical experience. Results: In individuals with mood disorders, ADHD is best diagnosed when typical symptoms persist during periods of sustained euthymia. Individuals with BD+ADHD, particularly those with bipolar I disorder (BD I), are at risk for mood destabilization with many ADHD treatments, and should be prescribed mood-stabilizing medications before initiating ADHD therapies. Bupropion is a reasonable first-line treatment for BD+ADHD, while mixed amphetamine salts and methylphenidate also may be considered in patients determined to be at low risk for manic switch. Modafinil and cognitive-behavioral therapy (CBT) are second-line choices. In patients with MDD+ADHD and moderate to severe depression, MDD should be the treatment priority, whereas in mildly depressed or euthymic patients the order may be reversed. First-line treatments for MDD+ADHD include bupropion, an antidepressant plus a long-acting stimulant, or an antidepressant plus CBT. Desipramine, nortriptyline, and venlafaxine are second-line options. Conclusions: Clinicians should be vigilant in screening for comorbid ADHD in mood disorder patients. ADHD symptoms can respond to appropriately chosen treatments.
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In the citing paper
“Patients with comorbid ADHD often experience a more treatment‐refractory course, more mood episodes, greater functional impairment and a heightened risk of suicide.765”
In the citing paper
“For ADHD, CBT can improve both depressive and ADHD symptoms.”
From Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder (2016) · cites this paper as [22]
In the citing paper
“Studies of neurotransmitters have also pointed to abnormalities in dopamine (DA) and norepinephrine (NE) signaling [16,45]”
From Adult ADHD and comorbid disorders: clinical implications of a dimensional approach (2017) · cites this paper as [16]
In the citing paper
“Neuroimaging studies have implicated differences in volume and activity in the frontal lobe, which is responsible for attention, behaviour selection, and emotion [16].”
From Adult ADHD and comorbid disorders: clinical implications of a dimensional approach (2017) · cites this paper as [16]
In the citing paper
“However, there is a theoretical risk of stimulant therapy resulting in mood destabilization in individuals with bipolar disorder [16].”
From Adult ADHD and comorbid disorders: clinical implications of a dimensional approach (2017) · cites this paper as [16]
In the citing paper
“Antidepressants such as venlafaxine and bupropion have also been evaluated as treatment options for ADHD, with some evidence of benefit in addressing ADHD symptoms [16,109].”
From Adult ADHD and comorbid disorders: clinical implications of a dimensional approach (2017) · cites this paper as [16]
In the citing paper
“However, it has also been noted that ADHD treatment may not be as effective in individuals with active depression [16].”
From Adult ADHD and comorbid disorders: clinical implications of a dimensional approach (2017) · cites this paper as [16]
Citations
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Cited by
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Yatham, L. N., Kennedy, S. H., Parikh, S. V., Schaffer, A., Bond, D. J., Frey, B. N., Sharma, V., Goldstein, B. I., Rej, S., Beaulieu, S., et al. (2018) · Bipolar Disorders · doi:10.1111/bdi.12609 · Cited by 1,852
Self-citationKennedy, S. H., Lam, R. W., McIntyre, R. S., Tourjman, S. V., Bhat, V., Blier, P., Hasnain, M., Jollant, F., Levitt, A. J., MacQueen, G. M., et al. (2016) · The Canadian Journal of Psychiatry · doi:10.1177/0706743716659417 · Cited by 1,181
Self-citationAdult ADHD and comorbid disorders: clinical implications of a dimensional approach
Katzman, M. A., Bilkey, T. S., Chokka, P. R., Fallu, A., & Klassen, L. J. (2017) · BMC Psychiatry · doi:10.1186/s12888-017-1463-3 · Cited by 732
“As such, one can imagine this low hedonic tone as a key feature shared by MDD and resulting from a shared dysfunction in monoamine signaling, particularly in the ventral striatum [52].”
BackgroundResultInfluentialParikh, S. V., Quilty, L. C., Ravitz, P., Rosenbluth, M., Pavlova, B., Grigoriadis, S., Velyvis, V., Kennedy, S. H., Lam, R. W., MacQueen, G. M., et al. (2016) · The Canadian Journal of Psychiatry · doi:10.1177/0706743716659418 · Cited by 562
Self-citationFountoulakis, K. Ν., Grunze, H., Vieta, E., Young, A. H., Yatham, L. N., Blier, P., Kasper, S. F., & Moeller, H. J. (2016) · The International Journal of Neuropsychopharmacology · doi:10.1093/ijnp/pyw109 · Cited by 248
Metadata
- Authors
- Bond, D. J., Hadjipavlou, G., Lam, R. W., McIntyre, R. S., Beaulieu, S., Schaffer, A., & Weiss, M.
- Affiliations
- University of British Columbia (CA)
- University Health Network (CA)
- Douglas Mental Health University Institute (CA)
- Sunnybrook Health Science Centre (CA)
- Children's & Women's Health Centre of British Columbia (CA)
- Corresponding author
- Bond, David J.
- ORCID
- Venue
- Annals of Clinical Psychiatry
- Publisher
- SAGE Publications
- Published
- 2012-02
- Volume
- 24
- Issue
- 1
- Pages
- 23-37
- ISSN
- 1040-1237 (ISSN-L)
- 1547-3325
- OpenAlex
- W48669398
- Cited by
- 133
- References
- 172
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 8 · 2023: 7 · 2022: 5 · 2021: 9 · 2020: 8 · 2019: 13 · 2018: 7 · 2017: 10 · 2016: 16 · 2015: 8 · 2014: 13 · 2013: 12 · 2012: 7
- FWCI
- 9.11
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed
- Funders
- Canadian Institutes of Health Research
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- attention deficit hyperactivity disorder, comorbidities, bipolar disorder, major depressive disorder, mood disorders, ADHD treatment, bupropion, mixed amphetamine salts, methylphenidate, modafinil, cognitive behavioral therapy, mood stabilizers, manic switch, ADHD screening, treatment guidelines
- MeSH terms
- Adult, Central Nervous System Stimulants, Antidepressive Agents, Attention Deficit Disorder with Hyperactivity, Bipolar Disorder, Canada, Major Depressive Disorder, Humans, Comorbidity, Cognitive Behavioral Therapy, Lithium Compounds, Mood Disorders, Advisory Committees
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