Could a history of hypomanic experiences potentially affect the chances of developing a substance use disorder?

This summary is based on a paper published from our lab and available on our website: “Subjective responses to amphetamine in young adults with previous mood elevation experiences”.

We studied young adults with a history of hypomanic episodes or mood elevations— a history of having repeated, exaggerated highs and lows in mood.

We studied young adults with a history of hypomanic episodes or mood elevations— a history of having repeated, exaggerated highs and lows in mood.

This study aimed to further understand the relationship between hypomanic experiences—or periods of mood elevation—and responses to drugs as a predictor for the likelihood of developing substance use disorders in young people. Previous research suggested that young adults who previously had hypomanic experiences reported less subjective effects when given a low dose of alcohol, and this may foreshadow future risk of addiction. The previous finding of a lower subjective response may be seen in other drugs beyond alcohol, such as amphetamine, and this was the topic of this research.

Dextroamphetamine, known as d-amphetamine, is commonly used to treat ADHD and narcolepsy. It is also a commonly abused substance.

Dextroamphetamine, known as d-amphetamine, is commonly used to treat ADHD and narcolepsy. It is also a commonly abused substance.

For this study, d-amphetamine was administered to healthy, young 18 and 19-year old participants recruited from the University of Chicago and its surrounding area. The participants had experienced various amounts of hypomanic experiences which had been measured using the Mood Disorders Questionnaire (MDQ) used to infer the possibility of an individual being diagnosed with BP.

Medical and psychiatric screening including an electrocardiogram, drug use and medical history, a physical exam, and a modified structural clinical interview (SCID) were also conducted by a clinical psychologist. The participants all participated in three 4-hour laboratory sessions where they received a placebo, 10mg, or 20mg d-amphetamine under double blind conditions; that is, both the participant and the researcher were blind as to which was administered at each session.

The results were similar as they previously were for alcohol: participants with higher MDQ scores experienced less stimulation after 10mg (the lower dose), but not 20mg (the higher dose), d-amphetamine, than individuals who had scored lower on the MDQ. This suggests that a previous history of hypomanic states is related to a dampened response to lower doses of psychostimulant drugs, as previously seen in alcohol. It is possible that the lower subjective effect on these participants contributes to a greater risk of subsequent drug use and/or misuse.