title: Prescribing trends of antidepressants in bipolar depression.
abstract: BACKGROUND
  This study utilizing pharmacoepidemiologic methods was undertaken to determine the prescribing patterns of antidepressants particularly in bipolar depression.
  
  
  METHODS
  From pharmacy records of the McLean Hospital, the number of patients receiving antidepressants and given electroconvulsive therapy (ECT) from June 1, 1987, to May 8, 1993, was determined. We later linked these data bases with patients who were diagnosed with DSM-III-R bipolar depression (296.5) during the same period of time.
  
  
  RESULTS
  During the 6-year period, it was determined that 3829 inpatients had received tricyclic antidepressants (TCAs), 2981 fluoxetine, 2603 trazodone, 809 bupropion, 743 monoamine oxidase inhibitors (MAOIs), 592 stimulants, 588 sertraline, 48 paroxetine, and 894 ECT. There were significant increases over time in prescriptions of MAOIs compared with fluoxetine (chi 2 = 14.36, p = .006), and bupropion compared with TCAs (chi 2 = 6.45, p = .04). There was a trend for bupropion to be prescribed more over time compared with fluoxetine (chi 2 = 5.09, p = .08). There were no significant changes in the prescribing of other antidepressants or in the use of ECT.
  
  
  CONCLUSIONS
  At our center, prescribing of bupropion and MAOIs in bipolar depression has increased significantly. This may be related to the reports in the literature of the low switch rates to mania with the use of these drugs.
authors.affiliation: Pharmacoepidemiology Center, McLean Hospital, Belmont, Mass. 02178, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Zarate
authors.forename: M
authors.initials: M
authors.lastname: Tohen
authors.forename: G
authors.initials: G
authors.lastname: Baraibar
authors.forename: J C
authors.initials: JC
authors.lastname: Kando
authors.forename: J
authors.initials: J
authors.lastname: Mirin
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000008:administration & dosage*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000453:epidemiology / Q000628:therapy; D016642:Bupropion / Q000008:administration & dosage; D003131:Combined Modality Therapy; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000639:trends; D004565:Electroconvulsive Therapy; D005260:Female; D006760:Hospitalization; D006801:Humans; D016239:MEDLINE; D008297:Male; D008996:Monoamine Oxidase Inhibitors / Q000008:administration & dosage; D017891:Pharmacoepidemiology; D010607:Pharmacy Service, Hospital / Q000706:statistics & numerical data / Q000639:trends
chemical_list: D000928:Antidepressive Agents; D008996:Monoamine Oxidase Inhibitors; D016642:Bupropion