Endoxifen for the management of bipolar disorder with comorbid substance use disorder: A report of two cases

Abstract

Bipolar disorder (BI) is a common occurrence and increases the risk of substance use disorder. This comorbidity has potentially serious consequences including suicide attempts, hospitalization, and rapid cycling. Endoxifen could play a role in the management of BI based on the inhibition of protein kinase C, which also has a role in substance abuse. We present two cases of patients with bipolar mania and comorbid substance use disorder, who were effectively and safely treated with adjunct Endoxifen. The addition of Endoxifen addition reduced manic symptoms as well as substance use. Furthermore, the inclusion of Endoxifen permitted the use of lower doses of other drugs in one patient and reduced the pill burden in the other patient. Endoxifen has the potential for use in the management of BI in patients with comorbid substance abuse.