The Maudsley bipolar disorder project. A survey of psychotropic prescribing patterns in bipolar I disorder.
OBJECTIVE
The outcome of Bipolar 1 Disorder (BD1) is greatly dependent on the adequacy and appropriateness of its treatment. As the treatment choices in BD1 disorder are increasing the aim of this study was to examine the current use of the pharmacological agents in BD1 patients and its association with clinical characteristics.


METHODS
Case note review of the pharmacotherapy of a sample of BD1 patients from a specified South London sector of a National Health Service Trust.


RESULTS
Half of the patients were on mood-stabilizers (usually lithium) and their use was associated with female gender and multiple admissions. Antipsychotics were more commonly used in patients with psychotic features and multiple manic episodes. Antidepressants were rarely prescribed alone and were not associated with increased number of manic episodes. Combination treatments were mostly used in patients in acute episodes and with multiple hospitalizations.


CONCLUSIONS
In ordinary care, the treatment of BD1 is often driven by symptoms and falls short of the existing practice guidelines.
Frangou
Sophia
S
Section of Neurobiology of Psychosis, Division of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, London, UK. s.frangou@iop.kcl.ac.uk
Raymont
Vanessa
V
Bettany
David
D
D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000145:classification / Q000188:drug therapy* / Q000453:epidemiology; D016009:Chi-Square Distribution; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004359:Drug Therapy, Combination; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D011619:Psychotropic Drugs / Q000145:classification / Q000627:therapeutic use*; D016896:Treatment Outcome
D011619:Psychotropic Drugs