title: Polypharmacy and suicide attempts in bipolar disorder.
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.
  
  
  METHODS
  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.
authors: Post-graduate Psychiatry Program, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors: Fernando Kratz
authors: FK
authors: Gazalle
authors: Pedro Curi
authors: PC
authors: Hallal
authors: Juliana
authors: J
authors: Tramontina
authors: Adriane Ribeiro
authors: AR
authors: Rosa
authors: Ana Cristina
authors: AC
authors: Andreazza
authors: Vanessa
authors: V
authors: Zanatto
authors: Aida
authors: A
authors: Santin
authors: Flávio
authors: F
authors: Kapczinski
authors: Keila Maria
authors: KM
authors: Ceresér
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000928:Antidepressive Agents / Q000627:therapeutic use*; D018692:Antimanic Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy / Q000453:epidemiology*; D001938:Brazil / Q000453:epidemiology; D015897:Comorbidity; D004359:Drug Therapy, Combination; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D018020:Lithium Compounds / Q000627:therapeutic use; D008297:Male; D019338:Polypharmacy; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D014635:Valproic Acid / Q000627:therapeutic use
chemical_list: D000928:Antidepressive Agents; D018692:Antimanic Agents; D014150:Antipsychotic Agents; D018020:Lithium Compounds; D014635:Valproic Acid