Aripiprazole for Bipolar Disorder and Alcohol Use Disorder

Exclusion Criteria

• •Baseline Hamilton Rating Scale for Depression (HRSD) or Young Mania Rating Scale (YMRS) scores \> 35
• •Mood disorders other than bipolar I, II, NOS or schizoaffective disorder bipolar type (e.g. cyclothymic disorders, schizophrenia, schizoaffective disorder depressive type, or unipolar depression based on the SCID), other disorders, e.g. anxiety disorders, will be allowed.
• •Current diagnosis of amphetamine or cocaine use disorder or a cocaine or amphetamine positive baseline urine sample.
• •Evidence of clinically significant alcohol withdrawal symptoms
• •Current treatment with an atypical antipsychotic
• •Current treatment with naltrexone, acamprosate, disulfiram, or topiramate in the last 28 days
• •Prior treatment with Aripiprazole within the last year or lifetime history of intolerable side effects to Aripiprazole
• •Vulnerable populations (e.g. pregnant, nursing, cognitively impaired, incarcerated.)
• •Evidence of clinically significant alcohol withdrawal symptoms defined as a CIWA-Ar score of ≥ 10.
• •High risk for suicide
• •Aspartate Amino Transferase (AST) or Alanine Amino Transferase (ALT) \> 3 times upper limit of normal
• •Current use of Cytochrome P450 3A4 inducing medication (e.g. carbamazepine, rifabutin, rifampin, ritonavir).
• •Use of other substances (besides cocaine/amphetamine) is allowed if the use disorder is no greater than moderate severity and alcohol is the self-identified substance of choice.
• •History of neuroleptic malignant syndrome or tardive dyskinesia.