The clinical utility of mood stabilizers, in particular antiepileptics, has been established as safe and effective in substance users with and without comorbid mood disorders. The central features of bipolar disorder are sustained mood swings that can range from depression to hypomania or mania. Mood stabilizers reduce the severity and frequency of these changes. Some mood stabilizers for bipolar disorder are prescribed when acute symptoms of mania occur.
Other mood stabilizers are prescribed as maintenance medications, intended to limit the level of mood symptoms as they manifest or sooner. In addition to mood stabilizing agents, adjuvant pharmacotherapies for addiction should also be considered in the treatment of patients with a double diagnosis. Naltrexone has been shown to significantly reduce the severity of manic and depressive symptoms and to decrease alcohol consumption in patients with bipolar disorder and alcohol dependence, 18.