Polypharmacy and suicide attempts in bipolar disorder.
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.
Gazalle
Fernando Kratz
FK
Post-graduate Psychiatry Program, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Hallal
Pedro Curi
PC
Tramontina
Juliana
J
Rosa
Adriane Ribeiro
AR
Andreazza
Ana Cristina
AC
Zanatto
Vanessa
V
Santin
Aida
A
Kapczinski
Flávio
F
Ceresér
Keila Maria
KM
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
D000928:Antidepressive Agents; D018692:Antimanic Agents; D014150:Antipsychotic Agents; D018020:Lithium Compounds; D014635:Valproic Acid