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Article Dans Une Revue Bipolar Disorders Année : 2023

Patterns of pharmacotherapy for bipolar disorder: A GBC survey

Balwinder Singh
Anastasia Yocum
Rebecca Strawbridge
Sarah Sperry
Brandon Coombes
Melanie Ashton
  • Fonction : Auteur
Lana Williams
Kamyar Keramatian
Ana Andreazza

Résumé

Abstract Objectives To understand treatment practices for bipolar disorders (BD), this study leveraged the Global Bipolar Cohort collaborative network to investigate pharmacotherapeutic treatment patterns in multiple cohorts of well‐characterized individuals with BD in North America, Europe, and Australia. Methods Data on pharmacotherapy, demographics, diagnostic subtypes, and comorbidities were provided from each participating cohort. Individual site and regional pooled proportional meta‐analyses with generalized linear mixed methods were conducted to identify prescription patterns. Results This study included 10,351 individuals from North America ( n = 3985), Europe ( n = 3822), and Australia ( n = 2544). Overall, participants were predominantly female (60%) with BD‐I (60%; vs. BD‐II = 33%). Cross‐sectionally, mood‐stabilizing anticonvulsants (44%), second‐generation antipsychotics (42%), and antidepressants (38%) were the most prescribed medications. Lithium was prescribed in 29% of patients, primarily in the Australian (31%) and European (36%) cohorts. First‐generation antipsychotics were prescribed in 24% of the European versus 1% in the North American cohort. Antidepressant prescription rates were higher in BD‐II (47%) compared to BD‐I (35%). Major limitations were significant differences among cohorts based on inclusion/exclusion criteria, data source, and time/year of enrollment into cohort. Conclusions Mood‐stabilizing anticonvulsants, second‐generation antipsychotics, and antidepressants were the most prescribed medications suggesting prescription patterns that are not necessarily guideline concordant. Significant differences exist in the prescription practices across different geographic regions, especially the underutilization of lithium in the North American cohorts and the higher utilization of first‐generation antipsychotics in the European cohorts. There is a need to conduct future longitudinal studies to further explore these differences and their impact on outcomes, and to inform and implement evidence‐based guidelines to help improve treatment practices in BD.

Dates et versions

inserm-04198042 , version 1 (06-09-2023)

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Citer

Balwinder Singh, Anastasia Yocum, Rebecca Strawbridge, Katherine Burdick, Caitlin Millett, et al.. Patterns of pharmacotherapy for bipolar disorder: A GBC survey. Bipolar Disorders, 2023, 327 (1), pp.115373. ⟨10.1111/bdi.13366⟩. ⟨inserm-04198042⟩
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