Psychotropic polypharmacy for the treatment of bipolar disorder in Taiwan

Psychiatr Serv. 2014 Jan 1;65(1):125-8. doi: 10.1176/appi.ps.201200529.

Abstract

Objective: Psychotropic polypharmacy in the treatment of bipolar disorder has proliferated. Yet evidence about the prevalence and predictors of different combinations of polypharmacy in inpatient settings is scarce.

Methods: The Nationwide Psychiatric Inpatient Medical Claims (2000-2007) in Taiwan were used to examine prescriptions for mood stabilizers, antipsychotics, and antidepressants among recently discharged patients with bipolar disorder (N=5,449; 51% women, mean±SD age=36.8±12.4).

Results: A total of 71% of prescriptions involved between-class polypharmacy, and 17% involved within-class polypharmacy. Patients older than 50 and patients at medical centers (>500 beds) were less likely to receive polypharmacy. Lower prescribed doses predicted polypharmacy. Receiving polypharmacy was not associated with a higher rate of readmission within one year.

Conclusions: There was substantial use of various forms of polypharmacy in the treatment of inpatients with bipolar disorder. Randomized studies should be used to compare the cost-effectiveness of common psychotropic combinations and monotherapy to treat bipolar disorder.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antidepressive Agents / administration & dosage
  • Antidepressive Agents / therapeutic use
  • Antimanic Agents / administration & dosage
  • Antimanic Agents / therapeutic use
  • Antipsychotic Agents / administration & dosage
  • Antipsychotic Agents / therapeutic use
  • Bipolar Disorder / drug therapy*
  • Drug Prescriptions / statistics & numerical data*
  • Drug Utilization / statistics & numerical data
  • Female
  • Humans
  • Male
  • Middle Aged
  • Polypharmacy*
  • Psychotropic Drugs / administration & dosage
  • Psychotropic Drugs / classification
  • Psychotropic Drugs / therapeutic use*
  • Taiwan

Substances

  • Antidepressive Agents
  • Antimanic Agents
  • Antipsychotic Agents
  • Psychotropic Drugs