title: Pharmacotherapy of Bipolar Affective Disorder: A Hospital based Study from Sub Himalayan Valley of Nepal.
abstract: BACKGROUND
  In Bipolar disorder the mood of the patients fluctuates between depression and mania. The main objective of the study was to find out the commonest mood stabilizers used for the treatment of Bipolar affective disorders in Western Nepal in hospitalized patients in an actual clinical set up.
  
  
  METHODS
  This was a cross-sectional study which was conducted between October 2009 and September 2010 at Psychiatric ward at Manipal teaching hospital, Pokhara, Nepal, a tertiary care hospital situated in Western Nepal. The diagnosis of the disease was based on ICD-10 (Tenth revision) Classification of mental and Behavioural disorders, Diagnostic Criteria for Research. We calculated odds ratio and their 95% confidence intervals (95% CI). p< 0.05 was considered as statistically significant.
  
  
  RESULTS
  62.1% of the patients were less than 40 yrs, 56.3% were male, 72.4% were unemployed and 75.9% of the patients were having monthly income <10,000/month. As far as ethnicity is concerned 37.9% of the cases were Brahmin and by occupation 29.9% of the patients were students followed by housewife 25.3%, labour 17.2%, retired 13.8% respectively. Drugs and Psychotherapy [OR 1.4, 95% (CI 0.575, 3.4017)] was prescribed in age <40 years as compared to age>40 yrs. Male patients [OR 7.22, 95% (CI 0.862, 60.499)] and [OR 2.353, 95% (CI 0.857, 6.455)] received drugs by trade names and drugs not from the national drug list of Nepal as compared to females. Monthly income <10,000/month and [OR 2.8, 95% (CI 0.742, 10.56)] tendency of receiving drugs by trade names. Among the mood elevators Sodium valproate was the commonest drug to be prescribed in 51/87(58.6%) patients followed by Lithium in 30/87 (34.5%) cases and Carbamazepine in 6/87 (6.9%) cases. Sodium valproate was prescribed at 1,000 mg/day, Lithium was prescribed at 900 mg/day in and Carbamazepine was prescribed at 800 mg/day.
  
  
  CONCLUSIONS
  Among all the mood elevators Sodium valproate is the commonest drug prescribed for the treatment of bipolar affective disorder, recommended that there is a trend of using newer drugs like sodium valproate rather than the conventional mood stabilizers like Lithium for bipolar affective disorder in Western Development region of Nepal.
authors.affiliation: Lecturer, Department of Pharmacology, Manipal College of Medical Sciences , Pokhara, Nepal .
authors.forename: Indrajit
authors.initials: I
authors.lastname: Banerjee
authors.affiliation: Assistant Professor, Department of Community Medicine, Manipal College of Medical Sciences , Pokhara, Nepal .
authors.forename: Brijesh
authors.initials: B
authors.lastname: Sathian
authors.affiliation: Professor, Department of Psychiatry, Manipal Teaching Hospital , Pokhara, Nepal .
authors.forename: Prasanta Kumar
authors.initials: PK
authors.lastname: Chakraborty
authors.affiliation: Post Doctorate Trainee, Department of Urology, SMS Medical College Jaipur , Rajasthan, India .
authors.forename: Indraneel
authors.initials: I
authors.lastname: Banerjee
authors.affiliation: Assistant Professor, Department of Physiology, Manipal College of Medical Sciences , Pokhara, Nepal .
authors.forename: Bedanta
authors.initials: B
authors.lastname: Roy
authors.affiliation: Professor, Department of Pharmacology, Manipal College of Medical Sciences , Pokhara, Nepal .
authors.forename: Akhilesh Chandra
authors.initials: AC
authors.lastname: Jauhari
authors.affiliation: Professor and Head of the Department of Pharmacology, Manipal College of Medical Sciences , Pokhara, Nepal .
authors.forename: Archana
authors.initials: A
authors.lastname: Saha
keywords: Bipolar disorder; Depression; Mania; Mood stabilizers; Pharmacotherapy