title: Changing Trends in Treatment of Acute Mania: Experience of a Tertiary Centre Over a Decade.
abstract: We investigated trends over a decade in the prescription of lithium, antiepileptics, and antipsychotic agents at discharge for patients hospitalised for acute mania. We conducted a retrospective review of medical records for 165 inpatients with acute mania who had been hospitalised in Cerrahpaşa Faculty of Medicine, Department of Psychiatry during 2001-2002 and 2011-2012. Among 165 patients, prescription of olanzapine at discharge increased from 3 to 46 % (p < 0.001), while prescription of haloperidol decreased from 55 to 21 % (p < 0.001). Use of other atypical antipsychotics did not change significantly (risperidone decreased from 14 to 11 %, p = 0.5; quetiapine increased from 10 to 16 %, p = 0.2). Use of valproate, carbamazepine, and lithium did not change significantly. Use of electroconvulsive therapy in acute mania decreased by half from 27 to 13 % (p = 0.02). Typical antipsychotics alone or in combination with antiepileptics were the most common treatment regimen at discharge at 2001-2002; while 10 years later, they had been largely replaced by lithium or antiepileptics combined with second generation antipsychotics. Antipsychotic agents remained to be an important component of acute treatment of mania in our practice.
authors.affiliation: Department of Psychiatry, Cerrahpaşa Faculty of Medicine, Cerrahpaşa Medical School, Istanbul University, Halaskargazi c. No:81 Çiçek apt. daire:8, Istanbul, Turkey.
authors.forename: Mehmet Kemal
authors.initials: MK
authors.lastname: Arıkan
authors.affiliation: Department of Psychiatry, Cerrahpaşa Faculty of Medicine, Cerrahpaşa Medical School, Istanbul University, Halaskargazi c. No:81 Çiçek apt. daire:8, Istanbul, Turkey. canaaksoy@yahoo.com.
authors.forename: Cana Aksoy
authors.initials: CA
authors.lastname: Poyraz
authors.affiliation: Department of Psychiatry, Cerrahpaşa Faculty of Medicine, Cerrahpaşa Medical School, Istanbul University, Halaskargazi c. No:81 Çiçek apt. daire:8, Istanbul, Turkey.
authors.forename: Alper
authors.initials: A
authors.lastname: Baş
authors.affiliation: Department of Psychiatry, Cerrahpaşa Faculty of Medicine, Cerrahpaşa Medical School, Istanbul University, Halaskargazi c. No:81 Çiçek apt. daire:8, Istanbul, Turkey.
authors.forename: N Gamze Usta
authors.initials: NG
authors.lastname: Sağlam
authors.affiliation: Department of Psychiatry, Cerrahpaşa Faculty of Medicine, Cerrahpaşa Medical School, Istanbul University, Halaskargazi c. No:81 Çiçek apt. daire:8, Istanbul, Turkey.
authors.forename: Gizem Cetiner
authors.initials: GC
authors.lastname: Batun
authors.affiliation: Department of Psychiatry, Cerrahpaşa Faculty of Medicine, Cerrahpaşa Medical School, Istanbul University, Halaskargazi c. No:81 Çiçek apt. daire:8, Istanbul, Turkey.
authors.forename: Gözde
authors.initials: G
authors.lastname: Gültekin
authors.affiliation: Department of Psychiatry, Cerrahpaşa Faculty of Medicine, Cerrahpaşa Medical School, Istanbul University, Halaskargazi c. No:81 Çiçek apt. daire:8, Istanbul, Turkey.
authors.forename: Burç Çağrı
authors.initials: BÇ
authors.lastname: Poyraz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy / Q000628:therapy*; D004359:Drug Therapy, Combination / Q000639:trends*; D004363:Drug Utilization / Q000639:trends*; D004565:Electroconvulsive Therapy / Q000639:trends*; D005260:Female; D006801:Humans; D018020:Lithium Compounds / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D014150:Antipsychotic Agents; D018020:Lithium Compounds
keywords: Acute mania; Bipolar disorder; ECT; Pharmacotherapy