What treatment considerations need to be taken into account with co-occurring attention-deficit hyperactivity disorder (ADHD) and bipolar disorder?

Adults with both bipolar disorder and ADHD are more likely to have had an early onset. There is a high percentage of substance abuse in this group, and being able to clearly identify mood states is difficult.

Pharmacological regimens can become complicated and there are few controlled studies in this complex group to guide the practitioner.