P-169 - Adjuvant treatment in bipolar disorder

Abstract

Introduction: The use of monotherapy with mood stabilisers during bipolar disorder concerns only few patients. Neuroleptics, benzodiazepines and recently the new-generation antipsychotic molecules are widely used as adjuvant therapy to mood stabilizers, indeed beyond the indications held by the guidelines. Objectives: Modalities of prescription of psychotropic medication during the first admission and over a three-year follow-up in subjects with bipolar disorder. Aims: Evaluate the adequacy of prescribing practices in naturalistic conditions and international guidelines. Methods: Retrospective study of all first-admitted patients with bipolar disorder in two psychiatric wards of Razi Hospital between 2006 and 2OO8 and over a three-year follow-up. Results: Our sample consisted of 72 patients. Over 80% of patients had initially received an incisive antipsychotic drug in combination with mood stabilizer; it was a conventional antipsychotic in 65.3%. Sedative neuroleptics were prescribed in 40.3% of cases with a duration average of 19.21 ± 11.97 months. The combination of two antipsychotic drugs was found in 33.3% of patients. The most frequent association was "haloperidol-chlorpromazine" (79%). Benzodiazepines were prescribed in acute phase in the majority of the sample (94%) with a duration average of 27mo is ±8.4 months; it was the lorazepam in 70.6%. Conclusions: Theoretical recommendations do not always reflect the practical situations. Evaluating indications and conditions of polytherapy are critical issues in future studies on the biological treatment of bipolar disorder.