title: Use of polypharmacy and self-reported mood in outpatients with bipolar disorder.
abstract: Objective. As polypharmacy is routinely used for the treatment of bipolar disorder, the relation between the daily number of psychotropic medications and self-reported mood was investigated. Method. Eighty patients (35 men and 45 women) with a diagnosis of bipolar disorder I or II, recruited from academic centres, entered their mood, sleep, and psychotropic medications for 3 months into ChronoRecord software. A total of 8662 days of data was received (mean 114.7 days/per patient). Results. Seventy-nine patients took a mean of 3.8 medications daily (SD 1.7; range 1-9); one took none. Of these patients, 73 (92.4%) took mood stabilizers, 47 (58.8%) took antidepressants, 31 (38.8%) took antipsychotics, 34 (42.5%) took benzodiazepines and 17 (21.1%) took thyroid hormones. Patients reporting normal mood more frequently took fewer medications; the Pearson correlation coefficient between the number of medications and the percent of days normal was -0.481 (P < 0.001). Grouping by number of medications, ANOVA analysis showed those taking fewer medications reported normal mood more frequently (P<0.001). Conclusion. Combination treatment regimens are routinely prescribed for bipolar disorder. Patients reporting normal mood more frequently took a fewer number of daily medications. Studies are needed to better identify those patients who would benefit from polypharmacy and to optimise the combinations of medications for patients with refractory disorder.
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité - University Medicine Berlin, Campus Charité-Mitte (CCM), Germany.
authors.forename: Mazda
authors.initials: M
authors.lastname: Adli
authors.forename: Peter C
authors.initials: PC
authors.lastname: Whybrow
authors.forename: Paul
authors.initials: P
authors.lastname: Grof
authors.forename: Natalie
authors.initials: N
authors.lastname: Rasgon
authors.forename: Laszlo
authors.initials: L
authors.lastname: Gyulai
authors.forename: Christopher
authors.initials: C
authors.lastname: Baethge
authors.forename: Tasha
authors.initials: T
authors.lastname: Glenn
authors.forename: Michael
authors.initials: M
authors.lastname: Bauer
keywords: Bipolar disorder; combination therapy; polypharmacy; self-reported mood