Hoo Rim Song1, Young-Joon Kwon1, Won-Myong Bahk2, Young Sup Woo2, Hwang-Bin Lee3, Jonghun Lee4, Dae-Bo Lee2,5, Sang-Yeol Lee6, Moon-Doo Kim7, Seunghee Won8, Kwanghun Lee9, Inki Sohn10, Jung Goo Lee11,12, Young-Chul Shin13, Sangkeun Chung14, Saeheon Jang15, Young Myo Jae15, Bo-Hyun Yoon16. 1. Department of Psychiatry, College of Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea. 2. Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea. 3. Department of Psychiatry, Seoul National Hospital, Seoul, Korea. 4. Department of Psychiatry, College of Medicine, Daegu Catholic University Medical Center, Daegu, Korea. 5. Department of Psychiatry, Gunsan Medical Center, Gunsan, Korea. 6. Department of Psychiatry, College of Medicine, Wonkwang University Hospital, Iksan, Korea. 7. Department of Psychiatry, School of Medicine, Jeju National University Hospital, Jeju, Korea. 8. Department of Psychiatry, College of Medicine, Kyungpook National University Hospital, Daegu, Korea. 9. Department of Psychiatry, School of Medicine, Dongguk University Gyeongju Hospital, Gyeongju, Korea. 10. Department of Psychiatry, Keyo Hospital, Keyo Medical Foundation, Uiwang, Korea. 11. Department of Psychiatry, College of Medicine, Haeudae Paik Hospital and Paik Institute for Clinical Research, Inje University, Busan, Korea. 12. Department of Health Sciences and Technology, Graduate School of Inje University, Gimhae, Korea. 13. Department of Psychiatry, College of Medicine, Sungkyunkwan University Kangbuk Samsung Hospital, Seoul, Korea. 14. Department of Psychiatry, College of Medicine, Chonbuk National University Hospital, Jeonju, Korea. 15. Department of Psychiatry, Bongseng Memorial Hospital, Busan, Korea. 16. Department of Psychiatry, Naju National Hospital, Naju, Korea.
Abstract
AIMS: We examined prescription patterns in maintenance treatment for recovered bipolar patients and compared these with acute treatments. METHODS: Using retrospective methods, the bipolar patients in clinical recovery (Clinical Global Impression Bipolar Version score ≤ 2 for 6 months) after acute episode were selected. We reviewed differences between prescription patterns at remission and after a maintenance period of at least 6 months. RESULTS: A total of 340 bipolar disorder patients were selected. During the maintenance period, more than half of the patients (192, 56.5%) took a mood stabilizer (MS) + antipsychotic (AP) combination. Among the MS, valproate (149, 43.8%) was most prescribed, and lithium (98, 28.8%) was second, but as patients moved into maintenance treatment, lithium use decreased, and the use of lamotrigine (86, 25.3%) increased. Preferred AP were quetiapine (125, 36.8%), aripiprazole (67, 19.7%), risperidone (48, 14.1%), and olanzapine (39, 11.5%). The use of olanzapine in maintenance was greatly decreased compared with that during acute treatment (67, 19.7%). Most patients did not take an antidepressant (AD), but the proportion using one or more AD was increased during maintenance (17.9% to 30.3%), and bupropion (28, 8.2%) was the preferred AD. Doses were decreased in all drugs, but lamotrigine was maintained at a dose of 133.2 ± 68.5 mg/day. CONCLUSIONS: The most common prescription combination for bipolar maintenance treatment was MS + AP. The use of AP was decreased, whereas the use of AD in combination with MS and/or AP was increased. The doses of MS and AP were generally decreased during the maintenance periods, with the exception of lamotrigine.
AIMS: We examined prescription patterns in maintenance treatment for recovered bipolarpatients and compared these with acute treatments. METHODS: Using retrospective methods, the bipolarpatients in clinical recovery (Clinical Global Impression Bipolar Version score ≤ 2 for 6 months) after acute episode were selected. We reviewed differences between prescription patterns at remission and after a maintenance period of at least 6 months. RESULTS: A total of 340 bipolar disorderpatients were selected. During the maintenance period, more than half of the patients (192, 56.5%) took a mood stabilizer (MS) + antipsychotic (AP) combination. Among the MS, valproate (149, 43.8%) was most prescribed, and lithium (98, 28.8%) was second, but as patients moved into maintenance treatment, lithium use decreased, and the use of lamotrigine (86, 25.3%) increased. Preferred AP were quetiapine (125, 36.8%), aripiprazole (67, 19.7%), risperidone (48, 14.1%), and olanzapine (39, 11.5%). The use of olanzapine in maintenance was greatly decreased compared with that during acute treatment (67, 19.7%). Most patients did not take an antidepressant (AD), but the proportion using one or more AD was increased during maintenance (17.9% to 30.3%), and bupropion (28, 8.2%) was the preferred AD. Doses were decreased in all drugs, but lamotrigine was maintained at a dose of 133.2 ± 68.5 mg/day. CONCLUSIONS: The most common prescription combination for bipolar maintenance treatment was MS + AP. The use of AP was decreased, whereas the use of AD in combination with MS and/or AP was increased. The doses of MS and AP were generally decreased during the maintenance periods, with the exception of lamotrigine.