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Changes in mood stabilizer prescription patterns in bipolar disorder

Journal article
Authors Alina (Aikaterini) Karanti
Mathias Kardell
U. Lundberg
Mikael Landén
Published in Journal of Affective Disorders
Volume 195
Pages 50-56
ISSN 0165-0327
Publication year 2016
Published at Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry
Pages 50-56
Language en
Keywords Bipolar disorder, Lithium, Lamotrigine, Quetiapine, Mood stabilizers, Antidepressants, polycystic ovarian syndrome, latest maintenance data, double-blind, i-disorder, international society, comparative efficacy, acute mania, follow-up, depression, lamotrigine, Neurosciences & Neurology, Psychiatry
Subject categories Psychiatry, Neurology, Neurosciences


Background: Lithium is a first line treatment option in bipolar disorder, but several alternative treatments have been introduced in recent years, such as antiepileptic and atypical antipsychotic drugs. Little is known about how this has changed the prescription patterns. We investigated possible changes in the use of mood stabilizers and antidepressants in Sweden during 2007-2013. Methods: Data was collected from Swedish registers: the National Quality Assurance Register for bipolar disorder (BipolaR), the Prescribed Drug Register, and the Patient Register. Logistic regression models with drug use as outcomes were used to adjust for confounding factors such as sex, age, year of registration, and subtypes of bipolar disorder. Results: In both bipolar subtypes, lithium use decreased steadily during the study period, while the use of lamotrigine and quetiapine increased. The use of valproate decreased in bipolar II disorder and the use of olanzapine decreased among women. The use of antidepressant remained principally unchanged but increased somewhat in bipolar I disorder. Limitations: We only report data from 2007 as the coverage of BipolaR prior to 2007 was too low to allow for reliable analyses. Conclusion: Significant changes in the prescription of drugs in the treatment of bipolar disorder have occurred in recent years in Sweden. Further studies are needed to clarify whether these changes alter the outcome in bipolar disorder. (C) 2016 Elsevier B.V. All rights reserved.

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