The Connection Between Fibromyalgia and Comorbid Bipolar Disorder

About one in five patients with fibromyalgia (FM) has comorbid bipolar disorder (BD), according to a new study published in the Journal of Affective Disorders.¹

The findings suggest that FM patients be screened for BD before receiving antidepressant therapy that might trigger mania when administered without a mood stabilizer.

Led by coauthors Paul Kudlow, MD and Joshua Rosenblat, MD, from the University of Toronto, Canada, the meta-analysis is the first to quantify the prevalence of BD in FM, and raises concerns about the common use of antidepressants in this population.

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Researchers pooled data from 9 studies that met the inclusion criteria of incidence or prevalence of BD in the FM sample, and calculated an odds ratio from the 4 case-control studies using standard meta-analytic methods.

Results showed that out of 806 patients diagnosed with fibromyalgia, 175 (21%) also had a diagnosis of bipolar disorder. Further analysis revealed that FM patients are 7.5 times more likely to also have bipolar disorder than those without fibromyalgia.

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Fibromyalgia is a disorder of unknown origin that is characterized by widespread pain, abnormal pain processing, sleep disturbance, fatigue, and psychological distress. Data from the Centers for Disease Control and Prevention indicates that the prevalence of FM is about 2%, affecting an estimated 5 million adults in 2005.¹