Predictors of a Shorter Time to Hospitalization in Patients with Bipolar Disorder: Medication during the Acute and Maintenance Phases and Other Clinical Factors

Shim, In Hee; Woo, Young Sup; Wang, Hee Ryung; Bahk, Won‐Myong

doi:10.9758/cpn.2017.15.3.248

Cited by 14 publications

(14 citation statements)

References 20 publications

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“…Analysis of factors other than drugs of interest showed that the inpatient meta‐visit had an RR of 1.68 over the outpatient meta‐visit for psychiatric hospitalization ( P < 2.23 × 10 −308 ), supporting the evidence that previous hospitalization is a strong predictor of subsequent hospital admission in patients with BD . Consistent with our data, baseline substance use disorder, psychosis, and use of anticonvulsants and anxiolytics were previously reported to be risk factors for hospitalization in BD .…”

Section: Discussionsupporting

confidence: 88%

“…Analysis of factors other than drugs of interest showed that the inpatient meta-visit had an RR of 1.68 over the outpatient metavisit for psychiatric hospitalization (P < 2.23 × 10 −308 ), supporting the evidence that previous hospitalization is a strong predictor of subsequent hospital admission in patients with BD. [29][30][31][32][33] Consistent with our data, baseline substance use disorder, psychosis, and use of anticonvulsants and anxiolytics were previously reported to be risk factors for hospitalization in BD. 30 The findings on the reduced risk of psychiatric hospitalizations for patients on antibiotics and non-steroidal anti-inflammatory drugs contribute to the evidence suggesting the importance of immune alterations, inflammation, and the microbiome in BDs.…”

Section: × 10 −12supporting

confidence: 90%

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Comprehensive comparison of monotherapies for psychiatric hospitalization risk in bipolar disorders

Nestsiarovich

Mazurie²,

Hurwitz³

et al. 2018

Bipolar Disorders

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This largest reported retrospective observational study on bipolar disorders pharmacotherapy to date demonstrates that the majority of patients end monotherapy within 2 months after treatment start. The risk of psychiatric hospitalization varied almost two-fold across individual medications. The data add to the evidence favoring lithium and mood stabilizer use in short-term bipolar disorder management. The findings that the dopaminergic drugs aripiprazole and bupropion had better outcomes than other members of their respective classes and that antidepressant outcomes may vary by baseline mood polarity merit further investigation.

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Section: Discussionsupporting

confidence: 88%

Section: × 10 −12supporting

confidence: 90%

Comprehensive comparison of monotherapies for psychiatric hospitalization risk in bipolar disorders

Nestsiarovich

Mazurie²,

Hurwitz³

et al. 2018

Bipolar Disorders

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“…However, other guidelines recommend MS or AAP monotherapy and combination therapy as a first-line modality in a same degree while MS+AAP combination therapy was ranked as TOC in KMAP-BP 2018. This might reflect that Korean experts were doubtful for the clinical effectiveness of mono-therapy and had laid stress on the superiority of combination therapy over monotherapy in terms of efficacy for mania based on results from the clinical trials and meta-analysis 39–44)…”

Section: Discussionmentioning

confidence: 99%

Korean Medication Algorithm for Bipolar Disorder 2018: Comparisons with Other Treatment Guidelines

Jeong

Bahk

Woo

et al. 2019

Clin Psychopharmacol Neurosci

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The objective of this study was to compare recommendations of the Korean Medication Algorithm Project for Bipolar Disorder 2018 (KMAP-BP 2018) with other recently published guidelines for treating bipolar disorder. We reviewed a total of five recently published global treatment guidelines and compared treatment recommendation of the KMAP-BP 2018 with those of other guidelines. For initial treatment of mania, there were no significant differences across treatment guidelines. All guidelines recommended mood stabilizer (MS) or atypical antipsychotic (AAP) monotherapy or a combination of an MS with an AAP as a first-line treatment strategy for mania. However, the KMAP-BP 2018 did not prefer monotherapy with MS or AAP for psychotic mania. Quetiapine, olanzapine and aripiprazole were the first-line AAPs for nearly all phases of bipolar disorder across guidelines. Most guidelines advocated newer AAPs as first-line treatment options for all phases while lamotrigine was recommended for depressive and maintenance phases. Lithium and valproic acid were commonly used as MSs in all phases of bipolar disorder. As research evidence accumulated over time, recommendations of newer AAPs (such as asenapine, cariprazine, paliperidone, lurasidine, long-acting injectable risperidone and aripiprazole once monthly) became prominent. KMAP-BP 2018 guidelines were similar to other guidelines, reflecting current changes in prescription patterns for bipolar disorder based on accumulated research data. Strong preference for combination therapy was characteristic of KMAP-BP 2018, predominantly in the treatment of psychotic mania and severe depression. Further studies were needed to address several issues identified in our review.

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“…The combination of a MS and an AD was recommended as the first-line treatment in KMAP-BP 2014, but the recommendation for this combination is downgraded to second-line in this revision. Evidence does not support the use of ADs in patients with bipolar depression 33 , 34) and it remains controversial. 35) The changes in the recommendation level for AD use in the KMAP-BP 2018 might reflect that all evidence-based guidelines consistently recommend limited use of ADs adjunctively with anti-manic agents in cases when ADs are needed.…”

Section: Discussionmentioning

confidence: 99%

Korean Medication Algorithm Project for Bipolar Disorder 2018 (KMAP-BP 2018): Fourth Revision

Woo

Bahk

Lee

et al. 2018

Clin Psychopharmacol Neurosci

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ObjectiveThe Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) was first published in 2002 through an expert consensus of opinion, and updated in 2006, 2010, and 2014. This study constitutes the fourth revision of the KMAP-BP.MethodsA 50-item questionnaire was used to obtain the consensus of experts regarding pharmacological treatment strategies for various phases of adult bipolar disorder and six items for pediatric bipolar disorder. The review committee included 84 Korean psychiatrists and 43 child and adolescent psychiatry experts.ResultsThe preferred first-step strategies for acute mania were the combination of a mood stabilizer (MS) and an atypical antipsychotic (AAP), MS monotherapy, and AAP monotherapy. A combination of a MS and an AAP, and AAP monotherapy were preferred for psychotic mania. The first-step strategies for mild to moderate bipolar depression were monotherapy with MS, AAP, or lamotrigine (LMT), and the combination of a MS and an AAP or LMT, or a combination of an AAP and LMT. The combination of two among a MS, AAP, and LMT were preferred for non-psychotic severe depression. A combination of a MS and an AAP or the combination of an AAP with an antidepressant or LMT were the first-line options for psychotic severe depression.ConclusionThe recommendations of the KMAP-BP 2018 have changed from the previous version by reflecting recent developments in pharmacotherapy for bipolar disorder. KMAP-BP 2018 provides clinicians with a wealth of information regarding appropriate strategies for treating patients with bipolar disorder.

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Predictors of a Shorter Time to Hospitalization in Patients with Bipolar Disorder: Medication during the Acute and Maintenance Phases and Other Clinical Factors

Cited by 14 publications

References 20 publications

Comprehensive comparison of monotherapies for psychiatric hospitalization risk in bipolar disorders

Comprehensive comparison of monotherapies for psychiatric hospitalization risk in bipolar disorders

Korean Medication Algorithm for Bipolar Disorder 2018: Comparisons with Other Treatment Guidelines

Korean Medication Algorithm Project for Bipolar Disorder 2018 (KMAP-BP 2018): Fourth Revision

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