Pharmacotherapeutic trends in 2231 psychiatric inpatients with bipolar depression from the International AMSP Project between 1994 and 2009

Greil, Waldemar; Häberle, Anne; Haueis, Patrick; Grohmann, Renate; Russmann, Stefan

doi:10.1016/j.jad.2011.10.033

Cited by 53 publications

(52 citation statements)

References 37 publications

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“…Escalations in anticonvulsant use can be partially attributed to their increased utilisation in bipolar disorder (Greil et al, 2012), the diagnosis of which has increased in recent years (Moreno et al, 2007). Finally, polypharmacy with psychotropics is now more prevalent in both adults and children despite little systematic evidence supporting this practice (Comer et al, 2010;Mojtabai and Olfson, 2010).…”

Section: Introductionmentioning

confidence: 99%

Trends in the utilisation of psychotropic medications in Australia from 2000 to 2011

Stephenson

Karanges

McGregor

2012

Aust N Z J Psychiatry

202

193

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Psychotropic utilisation markedly increased in Australia between 2000 and 2011. Some potential concerns include: (1) the continuing high use of benzodiazepines, particularly alprazolam, despite their problematic effects; (2) the rapid increase in serotonin noradrenaline reuptake inhibitor (SNRI) use, given their more complex side-effect profile relative to selective serotonin reuptake inhibitors (SSRIs); and (3) the dramatic increase in antidepressant prescriptions despite questions about the efficacy of these drugs in mild to moderate depression. Finally, some limitations are identified regarding use of the DDDs/1000/day metric, which can distort estimates of utilisation of specific drugs when the defined daily dose is higher or lower than the formulation most commonly dispensed by pharmacies.

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Section: Introductionmentioning

confidence: 99%

Trends in the utilisation of psychotropic medications in Australia from 2000 to 2011

Stephenson

Karanges

McGregor

2012

Aust N Z J Psychiatry

202

193

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“…Despite the precautions voiced in relation to the use of antidepressants in the treatment of bipolar disorder, previous reports suggest that the use of antidepressants is substantial (17,18) indicating a certain divergence between evidence-based guidelines and clinical practice (1,3,6). This is probably due to complex guidelines, which are not easily applied, when patients have a less straightforward symptom picture in terms of comorbidity, suicidal thoughts, substance misuse, etc.…”

Section: Introductionmentioning

confidence: 99%

Trends in the psychopharmacological treatment of bipolar disorder: a nationwide register-based study

Bjørklund

Horsdal

Mors

et al. 2015

Acta Neuropsychiatr.

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“…On entry to the STEP-BD study, 40% of the 4,035 patients were receiving three or more psychotropic drugs (Goldberg et al 2009). The drugs prescribed most frequently for bipolar disorder are mood stabilizers and antidepressants (Baldessarini et al 2006; Baldessarini et al 2008a; Bauer et al 2013a; Greil et al 2012; Hayes et al 2011; Haeberle et al 2012). Despite ongoing disagreement as to the role of antidepressants in the treatment of bipolar disorder (Altshuler et al 2003; Ghaemi et al 2008; Möller and Grunze 2000; Pacchiarotti et al 2013), long-term prescribing of antidepressants remains widespread in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Antidepressant dosage taken by patients with bipolar disorder: factors associated with irregularity

Bauer

Glenn²,

Alda

et al. 2013

Int J Bipolar Disord

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BackgroundThis study analyzed regularity in the daily dosage of antidepressants taken by patients with bipolar disorder and identified the factors associated with irregularity.MethodsDaily self-reported medication dosage taken and mood ratings were available from 144 patients who received treatment as usual. All 144 patients took the same antidepressant for at least 100 days. One hundred eleven of these patients were also taking a mood stabilizer. Approximate entropy (ApEn) was used to measure serial regularity in daily dosage. Regularity is the tendency that values within a time series remain the same on incremental comparisons. Drug holidays (missing three or more consecutive days) were also determined. Generalized estimating equations (GEE) were used to estimate if any demographic or clinical variables were associated with regularity.ResultsAlthough the mean percent of days missing doses was only 18.6%, there was a wide range of regularity in the daily antidepressant dosage. Drug holidays were common, occurring in 41% of the analyses. Factors significantly associated with irregularity were as follows: total number of psychotropic medications (p = 0.005), pill burden (p = 0.005), and depression (p = 0.015). Neither the percent of days missing doses nor the drug holidays were associated with any demographic or clinical factors. For patients taking both antidepressants and mood stabilizers, there was no significant difference in regularity in daily dosage between these drugs.DiscussionThere can be considerable irregularity in daily dosage despite a low percent of days missing doses. Medication regimen complexity and depressed mood are associated with increased irregularity. Daily regularity in drug dosage may be more dependent on the individual than on the specific drug. Research on the clinical impact of irregularity in daily dosage of antidepressants is needed.

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Pharmacotherapeutic trends in 2231 psychiatric inpatients with bipolar depression from the International AMSP Project between 1994 and 2009

Cited by 53 publications

References 37 publications

Trends in the utilisation of psychotropic medications in Australia from 2000 to 2011

Trends in the utilisation of psychotropic medications in Australia from 2000 to 2011

Trends in the psychopharmacological treatment of bipolar disorder: a nationwide register-based study

Antidepressant dosage taken by patients with bipolar disorder: factors associated with irregularity

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