Utilization of Psychopharmacological Treatment Among Patients With Newly Diagnosed Bipolar Disorder From 2001 to 2010

Abstract

This study presents patterns of pharmacological treatment in patients with newly diagnosed bipolar disorder in Taiwan for a 10-year study period. It would be of importance to further investigate causes and outcomes for polytherapy and nonadherence to psychotropic medications among patients with bipolar disorder.

Reducing the rehospitalization risk after a manic episode: A population based cohort study of lithium, valproate, olanzapine, quetiapine and aripiprazole in monotherapy and combinations

“…In conclusion, our results support recent RCT findings indicating that a combination therapy including olanzapine and a classic mood-stabilizer may be the most effective treatment option for preventing severe affective relapses after a manic episode. The present study indicates that clinicians may be right in joining the global trend of prescribing more combination therapies (Bjorklund et al, 2016;Chang et al, 2016), in particular when treating patients with a recent manic episode. I., Macmillan, I.C., McAllister-Williams, H., Miklowitz, D.R., Morriss, R., Munafo, M., Paton, C., Saharkian, B.J., Saunders, K., Sinclair, J., Taylor, D., Vieta, E., Young, A.H., 2016. Evidence-based guidelines for treating bipolar disorder: Revised third edition recommendations from the British Association for Psychopharmacology.…”

“…However, none of these observational studies have differentiated between patients with a recent manic, depressive or mixed episode, nor between patients with bipolar disorder type 1 and 2, limiting possible comparisons with RCTs. Further, comparisons between different treatment options have been restricted to only including one atypical antipsychotic and few, if any, combination therapies, although prescription trends around the world move towards an increased use of atypical antipsychotics and combination therapies (Bjorklund et al, 2016;Chang et al, 2016). Accordingly, this nationwide register based cohort study was designed to increase knowledge on the real-world effectiveness of prophylactic treatment options used after a manic episode.…”

The current state of benzodiazepines and Z-drugs use and their influences on bipolar disorder outcomes-A small sample analysis

“…Unfortunately, comorbid anxiety disorders are linked to more affective relapses, increased suicidality, sleep disturbances, and increased barriers to effective treatment (Hawke et al 2013). Benzodiazepines (BZDs) are taken by 25%-90% of patients with bipolar disorder (Chang et al 2016) to manage anxiety and insomnia (Baldwin et al 2013), despite their potential serious adverse effects, such as craving, withdrawal symptoms upon discontinuation, and increased falls, especially during long-term use (Janhsen et al 2015). There is also evidence that BZDs have direct depressogenic effects, which may be particularly harmful to individuals with bipolar disorder (Michelini et al 1996).…”

Initiation and long‐term use of benzodiazepines and Z‐drugs in bipolar disorder

“…Benzodiazepines are used by 25%‐90% of patients with bipolar disorder, despite the continuing controversy about their risks and benefits. This substance group is undisputedly effective and well tolerated in the short‐term management of anxiety and insomnia .…”