title: Pharmacological Treatment Patterns at Study Entry for the First 500 STEP-BD Participants.
abstract: OBJECTIVE
  This study assessed patterns of psychopharmacological treatment for bipolar disorder.
  
  
  METHODS
  Intake treatment data were examined for the first 500 patients in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study (1998 to 1999). Diagnoses were assessed by using the Structured Clinical Interview for DSM-IV mood modules. Data on treatments were obtained by interviewing patients during the initial psychiatric examination.
  
  
  RESULTS
  Of the 500 participants, 73.6 percent had bipolar I disorder, 23.0 percent had bipolar II disorder, and 3.4 percent had bipolar disorder not otherwise specified. Upon examination, 63.4 percent were euthymic, 24.6 percent were depressed, and 12.0 percent were experiencing manic, hypomanic, or mixed states. Standard mood stabilizers (lithium, valproate, or carbamazepine) were the most commonly prescribed class of drugs that participants were taking at intake (71.9 percent). The next most common class of agents was antidepressants (40.6 percent), followed by novel anticonvulsants (31.8 percent), second-generation neuroleptics (27.2 percent), and benzodiazepines (25.0 percent). Eleven percent of patients were treated with standard mood stabilizer monotherapy. These prescribing patterns were further analyzed by subtype of illness and compared with patterns in other clinical and community settings.
  
  
  CONCLUSIONS
  In a large, well-characterized cross-sectional analysis of prescription patterns in the U.S. psychiatric academic setting, patients with bipolar disorder were primarily treated with standard mood stabilizers, followed by moderate use of antidepressants, novel anticonvulsants, and second-generation neuroleptics. Results can be useful in understanding the current clinical standard of care, as well as in guiding research studies toward areas in which there is a relative absence of evidence to inform clinical practice. Studies of longitudinal prescribing patterns in bipolar disorder are also needed.
authors: Department of Psychiatry at Emory University in Atlanta, Georgia 30322, USA. nghaemi@emory.edu
authors: S Nassir
authors: SN
authors: Ghaemi
authors: Douglas J
authors: DJ
authors: Hsu
authors: Michael E
authors: ME
authors: Thase
authors: Stephen R
authors: SR
authors: Wisniewski
authors: Andrew A
authors: AA
authors: Nierenberg
authors: Sachiko
authors: S
authors: Miyahara
authors: Gary
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authors: Sachs