title: Substantial changes in prescription recommendations for bipolar disorder in Canada: 2002-2010.
abstract: OBJECTIVE
  We examined trends in prescription recommendations for treatment of bipolar disorder (BD) in Canada during 2002-2010.
  
  
  METHODS
  Data collected by IMS Brogan in a database known as the Canadian Disease and Therapeutic Index were used for this analysis. These data are collected from a representative physician panel who record each drug recommendation and reason for recommendation in their practices for 2 consecutive days each calendar quarter of the year. Prescription patterns of medications for BD, including lithium, anticonvulsants, antipsychotic agents, anxiolytics, and antidepressants, were evaluated both for general practitioners and for specialists.
  
  
  RESULTS
  The number of prescription recommendations for BD increased by 72.1% from 2002 to 2009, and then dropped by 24.8% from 2009 to 2010. This increase from 2002 to 2009, and subsequent decrease from 2009 to 2010, was observed for all classes of medications. The overall increase from 2002 to 2010 was statistically significant for the atypical antipsychotics (P = 0.04). The largest change for an individual drug during this period was a 438% increase in recommendations for quetiapine (P = 0.01).
  
  
  CONCLUSIONS
  The number of prescription recommendations for BD increased substantially from 2002 to 2009 and sharply dropped in the following year. These results suggest that the influence of the concept of the bipolar spectrum and its promotion may have resulted in a substantial increase in treatment that has recently begun to wane.
authors.affiliation: Department of Community Health Sciences and Hotchkiss Brain Institute Mental Health Centre for Research and Education, University of Calgary, Calgary, Alberta. bulloch@ucalgary.ca
authors.forename: Andrew G M
authors.initials: AG
authors.lastname: Bulloch
authors.forename: Lauren C
authors.initials: LC
authors.lastname: Bresee
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Beck
authors.forename: Scott B
authors.initials: SB
authors.lastname: Patten
mesh_terms: D001714:Bipolar Disorder / Q000188:drug therapy* / Q000453:epidemiology; D002170:Canada / Q000453:epidemiology; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000706:statistics & numerical data / Q000639:trends; D058006:General Practice / Q000379:methods / Q000706:statistics & numerical data / Q000639:trends; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends; D011619:Psychotropic Drugs / Q000145:classification / Q000627:therapeutic use
chemical_list: D011619:Psychotropic Drugs