title: Medication burden in bipolar disorder: a chart review of patients at psychiatric hospital admission.
abstract: Individuals with bipolar disorder (BD) often receive complex polypharmacy regimens as part of treatment, yet few studies have sought to evaluate patient characteristics associated with this high medication burden. This retrospective chart review study examined rates of complex polypharmacy (i.e., ≥4 psychotropic medications), patterns of psychotropic medication use, and their demographic and clinical correlates in a naturalistic sample of adults with bipolar I disorder (BDI; N=230) presenting for psychiatric hospital admission. Using a computer algorithm, a hospital administrator extracted relevant demographic, clinical, and community treatment information for analysis. Patients reported taking an average of 3.31 (S.D.=1.46) psychotropic medications, and 5.94 (S.D.=3.78) total medications at intake. Overall, 82 (36%) met criteria for complex polypharmacy. Those receiving complex polypharmacy were significantly more likely to be female, to be depressed, to have a comorbid anxiety disorder, and to have a history of suicide attempt. Women were significantly more likely than men to be prescribed antidepressants, benzodiazepines, and stimulants, even after controlling for mood episode polarity. Study data highlight the high medication burden experienced by patients with BD, especially those who are acutely symptomatic. Data also highlight the particularly high medication burden experienced by women with BD; a burden not fully accounted for by depression.
authors.affiliation: Alpert Medical School of Brown University and Butler Hospital, RI 02906, USA. Electronic address: Lauren_Weinstock@Brown.edu.
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Weinstock
authors.affiliation: Alpert Medical School of Brown University and Butler Hospital, RI 02906, USA.
authors.forename: Brandon A
authors.initials: BA
authors.lastname: Gaudiano
authors.affiliation: Alpert Medical School of Brown University and Butler Hospital, RI 02906, USA.
authors.forename: Gary
authors.initials: G
authors.lastname: Epstein-Lubow
authors.affiliation: Alpert Medical School of Brown University and Butler Hospital, RI 02906, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Tezanos
authors.affiliation: Alpert Medical School of Brown University and Butler Hospital, RI 02906, USA.
authors.forename: Cintly E
authors.initials: CE
authors.lastname: Celis-Dehoyos
authors.affiliation: Alpert Medical School of Brown University and Butler Hospital, RI 02906, USA.
authors.forename: Ivan W
authors.initials: IW
authors.lastname: Miller
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000150:complications / Q000188:drug therapy; D001714:Bipolar Disorder / Q000150:complications / Q000188:drug therapy*; D017281:Cost of Illness; D003863:Depression / Q000150:complications / Q000188:drug therapy; D005260:Female; D006760:Hospitalization; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D008875:Middle Aged; D019338:Polypharmacy; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012189:Retrospective Studies; D012737:Sex Factors; D013406:Suicide, Attempted; D055815:Young Adult
chemical_list: D011619:Psychotropic Drugs
keywords: Antidepressants; Benzodiazepines; Bipolar depression; Demography; Mood stabilizers; Polypharmacy; Psychopharmacology