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Pharmacopsychiatry 2009; 42(5): 169-174
DOI: 10.1055/s-0029-1220888
Review

© Georg Thieme Verlag KG Stuttgart · New York

Are Psychostimulants a Treatment Option in Mania?

U. Hegerl1 , C. Sander1 , S. Olbrich1 , P. Schoenknecht1
  • 1Department of Psychiatry, University of Leipzig, Leipzig, Germany
Further Information

Publication History

received 08.10.2008 revised 14.01.2009

accepted 15.01.2009

Publication Date:
01 September 2009 (online)

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Abstract

Mania and attention-deficit hyperactivity disorder (ADHD) show a high degree of symptom overlap and comorbidity. Clinical trials and case reports indicate that psychostimulants do not or only rarely trigger or aggravate manic episodes but can even produce rapid and pronounced antimanic effects. An explanatory model is presented here in which the sensation seeking, hyperactive behaviour observed in mania and ADHD is interpreted as an autoregulatory attempt to stabilize vigilance by increasing external stimulation. Accordingly, patients with both mania and ADHD show rapid declines to lower vigilance levels (e.g., sleep spindles in EEG) under resting conditions with low external stimulation. The “paradoxical” antimanic effect of psychostimulants possibly results from their vigilance stabilizing properties.

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Correspondence

U. Hegerl

Department of Psychiatry

University of Leipzig

Semmelweisstrasse 10

04103 Leipzig

Germany

Phone: +49/341/97 245 30

Fax: +49/341/97 245 39

Email: Ulrich.Hegerl@medizin.uni-leipzig.de