Polypharmacy and suicide attempts in bipolar disorder

Braz J Psychiatry. 2007 Mar;29(1):35-8.

Abstract

Objective: The aim of this study was to assess the association between suicide attempts and the use of multiple drugs in patients with bipolar disorder.

Method: One hundred sixty-nine bipolar disorder outpatients diagnosed using the DSM-IV Structured Clinical Interview were included. Demographic and socioeconomic data, number of medications currently in use, history of suicide attempts, number of years undiagnosed, age of onset and current psychiatric co-morbidities were assessed using a structured questionnaire and DSM-IV criteria. The main outcome measure was the number of psychotropic drugs currently in use.

Results: Approximately half of all patients (48.5%) presented a history of suicide attempt; 84% were using more than one medication, and 19% were using more than three drugs. The most frequent combinations of drugs used by these patients were: lithium + valproate (17%); lithium + antipsychotics (10%); lithium + valproate + antipsychotics (9%); and antidepressants + any drug (6%). The number of suicide attempts was associated with the use of multiple drugs.

Conclusions: Our findings support the notion that the use of combination therapy in bipolar disorder may be related to severity of the BD, such as number of suicide attempts.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age of Onset
  • Antidepressive Agents / therapeutic use*
  • Antimanic Agents / therapeutic use*
  • Antipsychotic Agents / therapeutic use*
  • Bipolar Disorder / drug therapy
  • Bipolar Disorder / epidemiology*
  • Brazil / epidemiology
  • Comorbidity
  • Drug Therapy, Combination
  • Epidemiologic Methods
  • Female
  • Humans
  • Interview, Psychological
  • Lithium Compounds / therapeutic use
  • Male
  • Polypharmacy*
  • Suicide, Attempted / statistics & numerical data*
  • Valproic Acid / therapeutic use

Substances

  • Antidepressive Agents
  • Antimanic Agents
  • Antipsychotic Agents
  • Lithium Compounds
  • Valproic Acid