A nationwide study on concordance with multimodal treatment guidelines in bipolar disorder

Renes, Joannes W.; Regeer, Eline J.; Hoogendoorn, Adriaan W.; Nolen, Willem A.; Kupka, Ralph

doi:10.1186/s40345-018-0130-z

Cited by 16 publications

(15 citation statements)

References 29 publications

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“…Thus, it would be interesting to complement the current essay with a pharmaco-epidemiological analysis, such as those carried out in other countries that have already been pointed out (Table 1). It should be noted, though, that the results obtained in this study are congruent with the pharmaco-epidemiological research performed in other countries (Parabiaghi et al, 2015;Renes et al, 2018) and with the only one published in Spain (Castells et al, 2006).…”

Section: Discussionsupporting

confidence: 91%

“…The apparently high prescription of lithium by Spanish psychiatrists agrees with the results that have recently been observed in the Netherlands, where 70% of patients diagnosed with BD or Schizoaffective Disorder were treated with lithium (Renes et al, 2018). Nevertheless, as it is mentioned above this percentage is signi cantly higher than in other neighboring countries (Kessing, 2019).…”

Section: Discussionsupporting

confidence: 87%

“…In fact, over the last two decades, the decrease in lithium´s use is not widespread and in certain countries the lithium´s prescription rate has remained high. In some countries, more than 50% of bipolar patients are treated with lithium while in the US for example, only the 17% (Kessing et al, 2019;Parabiaghi et al, 2015;Renes et al, 2018, Rhee et al, 2020 (Table 1).…”

Section: Introductionmentioning

confidence: 99%

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Overview of Lithium´s Use: A Nationwide Survey

Mendiola

Hidalgo‐Mazzei

Vieta

et al. 2020

Preprint

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Background: Lithium is considered the gold standard treatment for bipolar disorder (BD). Its use as a first-line treatment in BD is supported by current clinical guidelines and scientific evidence. However, over the last two decades it has been observed a downward tendency in lithium´s use in several developed countries. Based on a nationwide survey, the objective of this study is to analyze in a large sample of psychiatrists relevant issues of the use of lithium salts in BD.Methods: Data were collected through an anonymous survey sent by email among 500 psychiatrists who belong to a National Society of Psychiatry (Spanish Society of Biological Psychiatry). The survey is a self-administered questionnaire consisting of 21 items on the most key aspects of the use of lithium (indication, dosage, monitoring and information for patients).Results: 212 psychiatrists completed the survey. 70% of psychiatrists prescribe lithium to more than 50% of patients diagnosed with BD. Adverse effects are the main reason not to use lithium salts. Over 75% of the participants consider lithium salts the treatment of choice for the maintenance phase of BD, both in women and men. Most of the participants (> 50%) start lithium after the first affective episode, use conservative plasma concentrations (0.6-0.8 mmol/L) and generally prescribe it twice a day. 57% of psychiatrists who treat patients under 18 do not use lithium in this population. About 70% of the survey respondents use official protocols to inform and monitor patients who are on lithium treatment.Conclusions: From the results of the present study it can be concluded that the use of lithium in Spain is in line with the recommendations of the main international clinical guidelines and current scientific literature. The first reason not to prescribe lithium in our country is the perception of its adverse effects and not the aspects related to its practical use or its effectiveness. Considering that BD is a chronic disease that has a typical onset in adolescence, the reasons for the low rate of prescription of lithium salts in patients under 18 must be thoroughly studied.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Overview of Lithium´s Use: A Nationwide Survey

Mendiola

Hidalgo‐Mazzei

Vieta

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…In fact, over the last two decades, the decrease in lithium's use is not widespread, and in certain countries, lithium's prescription rate has remained high. In some countries, more than 50% of bipolar patients are treated with lithium, while in the US, for example, only 17% (Kessing 2019 ; Parabiaghi et al 2015 ; Renes et al 2018 ; Rhee et al 2020 ) (Table 1 ).…”

Section: Introductionmentioning

confidence: 99%

Overview of lithium's use: a nationwide survey

Mendiola

Hidalgo‐Mazzei

Vieta

et al. 2021

Int J Bipolar Disord

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Background Lithium is considered the gold standard treatment for bipolar disorder (BD). Current clinical guidelines and scientific evidence support its use as a first-line treatment in BD. However, over the last two decades, there has been a downward tendency in lithium's use in several developed countries. Based on a nationwide survey, this study's objective is to analyze in a large sample of psychiatrists relevant issues of the use of lithium salts in BD. Methods Data were collected through an anonymous survey sent by email among 500 psychiatrists who belong to a National Society of Psychiatry (Spanish Society of Biological Psychiatry). The survey is a self-administered questionnaire consisting of 21 items on the most key aspects of lithium's use (indication, dosage, monitoring, and information for patients). Results 212 psychiatrists completed the survey. 70% of psychiatrists prescribe lithium to more than 50% of patients diagnosed with BD. Adverse effects are the main reason not to use lithium salts. Over 75% of the participants consider lithium salts the treatment of choice for the maintenance phase of BD, both in women and men. Most of the participants (> 50%) start lithium after the first affective episode, use conservative plasma concentrations (0.6–0.8 mmol/L), and generally prescribe it twice a day. 57% of psychiatrists who treat patients under 18 do not use lithium in this population. About 70% of the survey respondents use official protocols to inform and monitor patients on lithium treatment. Conclusions From the results of the present study, it can be concluded that the use of lithium in Spain is in line with the recommendations of the main international clinical guidelines and current scientific literature. The first reason not to prescribe lithium in our country is the perception of its adverse effects and not the aspects related to its practical use or its effectiveness. Considering that BD is a chronic disease with a typical onset in adolescence, the low rate of prescription of lithium salts in patients under 18 must be thoroughly studied.

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“…Use of lithium decreased, while the use of lamotrigine, quetiapine, and antidepressants increased in Scandinavia according to population‐based studies and in the USA (see reference ). A total of 34% are prescribed lithium in Denmark, 55% in Sweden , and 70% in the Netherlands , whereas a US national market scan during 2002–2003 (see reference ) found that lithium was prescribed as the initial drug for 7.5% of patients only.…”

Section: Decreased Use Of Lithium In Clinical Practicementioning

confidence: 99%

Lithium as the drug of choice for maintenance treatment in bipolar disorder

Kessing

2019

Acta Psychiatr Scand

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A nationwide study on concordance with multimodal treatment guidelines in bipolar disorder

Cited by 16 publications

References 29 publications

Overview of Lithium´s Use: A Nationwide Survey

Overview of Lithium´s Use: A Nationwide Survey

Overview of lithium's use: a nationwide survey

Lithium as the drug of choice for maintenance treatment in bipolar disorder

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