title: Antipsychotic use patterns in persons initially treated with mood stabilizers: a naturalistic study.
abstract: BACKGROUND
  Little information is available on the pattern of use of antipsychotics in naturalistic conditions in persons initially treated with "conventional" mood stabilizers (lithium and anticonvulsants).
  
  
  METHODS
  Data on community prescriptions were extracted from the 2004-2006 claims database of a French health care insurance fund for self-employed workers. Patients included were those continuously exposed to mood stabilizers without concomitant dispensing of antipsychotics over at least a 3-month period.
  
  
  RESULTS
  Of the 3 958 persons included, 17.8% had at least one addition/switch to antipsychotics over the follow-up period. The most frequent pattern was addition of second-generation antipsychotics (SGAPs) (41%) or first-generation antipsychotics (FGAPs) (23%) to the mood stabilizer for a relatively short period of time. A switch from mood stabilizer to SGAPs (20%) or FGAPs (15%) was less frequent. Mood stabilizers alone were prescribed again in most patients with the addition of FGAPs (72%) or SGAPs (61%) to mood stabilizers. Conversely, the majority of patients with a switch from mood stabilizers to FGAPs (55%) or SGAPs (58%) went on with these latter treatments over the follow-up.
  
  
  CONCLUSIONS
  SGAPs are preferentially prescribed in combination with mood stabilizers and their pattern of use is similar to that of FGAPs.
authors.affiliation: INSERM U657, Université Victor Segalen, Bordeaux 2, France. helene.verdoux@u-bordeaux2.fr
authors.forename: H
authors.initials: H
authors.lastname: Verdoux
authors.forename: A
authors.initials: A
authors.lastname: Cougnard
authors.forename: G-R
authors.initials: GR
authors.lastname: Auleley
authors.forename: J
authors.initials: J
authors.lastname: Deligne
authors.forename: C
authors.initials: C
authors.lastname: Blum-Boisgard
authors.forename: B
authors.initials: B
authors.lastname: Bégaud
authors.forename: M
authors.initials: M
authors.lastname: Tournier
mesh_terms: D000328:Adult; D000368:Aged; D018692:Antimanic Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D003863:Depression / Q000188:drug therapy*; D004363:Drug Utilization; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012111:Residence Characteristics; D012189:Retrospective Studies
chemical_list: D018692:Antimanic Agents; D014150:Antipsychotic Agents