title: Current prescription pattern of maintenance treatments for bipolar patients in Korea: A focus on the transition from acute treatments.
abstract: OBJECTIVE
  We examined prescription patterns in maintenance treatment for recovered bipolar patients and compared these with acute treatments.
  
  
  METHODS
  Using retrospective methods, the bipolar patients in clinical recovery (Clinical Global Impression Bipolar Version score ≤ 2 for 6 months) after acute episode were selected. We reviewed differences between prescription patterns at remission and after a maintenance period of at least 6 months.
  
  
  RESULTS
  A total of 340 bipolar disorder patients were selected. During the maintenance period, more than half of the patients (192, 56.5%) took a mood stabilizer (MS) + antipsychotic (AP) combination. Among the MS, valproate (149, 43.8%) was most prescribed, and lithium (98, 28.8%) was second, but as patients moved into maintenance treatment, lithium use decreased, and the use of lamotrigine (86, 25.3%) increased. Preferred AP were quetiapine (125, 36.8%), aripiprazole (67, 19.7%), risperidone (48, 14.1%), and olanzapine (39, 11.5%). The use of olanzapine in maintenance was greatly decreased compared with that during acute treatment (67, 19.7%). Most patients did not take an antidepressant (AD), but the proportion using one or more AD was increased during maintenance (17.9% to 30.3%), and bupropion (28, 8.2%) was the preferred AD. Doses were decreased in all drugs, but lamotrigine was maintained at a dose of 133.2 ± 68.5 mg/day.
  
  
  CONCLUSIONS
  The most common prescription combination for bipolar maintenance treatment was MS + AP. The use of AP was decreased, whereas the use of AD in combination with MS and/or AP was increased. The doses of MS and AP were generally decreased during the maintenance periods, with the exception of lamotrigine.
authors.affiliation: Department of Psychiatry, College of Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
authors.forename: Hoo Rim
authors.initials: HR
authors.lastname: Song
authors.affiliation: Department of Psychiatry, College of Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
authors.forename: Young-Joon
authors.initials: YJ
authors.lastname: Kwon
authors.affiliation: Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Won-Myong
authors.initials: WM
authors.lastname: Bahk
authors.affiliation: Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Young Sup
authors.initials: YS
authors.lastname: Woo
authors.affiliation: Department of Psychiatry, Seoul National Hospital, Seoul, Korea.
authors.forename: Hwang-Bin
authors.initials: HB
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, College of Medicine, Daegu Catholic University Medical Center, Daegu, Korea.
authors.forename: Jonghun
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea.|Department of Psychiatry, Gunsan Medical Center, Gunsan, Korea.
authors.forename: Dae-Bo
authors.initials: DB
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, College of Medicine, Wonkwang University Hospital, Iksan, Korea.
authors.forename: Sang-Yeol
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, School of Medicine, Jeju National University Hospital, Jeju, Korea.
authors.forename: Moon-Doo
authors.initials: MD
authors.lastname: Kim
authors.affiliation: Department of Psychiatry, College of Medicine, Kyungpook National University Hospital, Daegu, Korea.
authors.forename: Seunghee
authors.initials: S
authors.lastname: Won
authors.affiliation: Department of Psychiatry, School of Medicine, Dongguk University Gyeongju Hospital, Gyeongju, Korea.
authors.forename: Kwanghun
authors.initials: K
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, Keyo Hospital, Keyo Medical Foundation, Uiwang, Korea.
authors.forename: Inki
authors.initials: I
authors.lastname: Sohn
authors.affiliation: Department of Psychiatry, College of Medicine, Haeudae Paik Hospital and Paik Institute for Clinical Research, Inje University, Busan, Korea.|Department of Health Sciences and Technology, Graduate School of Inje University, Gimhae, Korea.
authors.forename: Jung Goo
authors.initials: JG
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, College of Medicine, Sungkyunkwan University Kangbuk Samsung Hospital, Seoul, Korea.
authors.forename: Young-Chul
authors.initials: YC
authors.lastname: Shin
authors.affiliation: Department of Psychiatry, College of Medicine, Chonbuk National University Hospital, Jeonju, Korea.
authors.forename: Sangkeun
authors.initials: S
authors.lastname: Chung
authors.affiliation: Department of Psychiatry, Bongseng Memorial Hospital, Busan, Korea.
authors.forename: Saeheon
authors.initials: S
authors.lastname: Jang
authors.affiliation: Department of Psychiatry, Bongseng Memorial Hospital, Busan, Korea.
authors.forename: Young Myo
authors.initials: YM
authors.lastname: Jae
authors.affiliation: Department of Psychiatry, Naju National Hospital, Naju, Korea.
authors.forename: Bo-Hyun
authors.initials: BH
authors.lastname: Yoon
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000188:drug therapy*; D004359:Drug Therapy, Combination / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D060046:Maintenance Chemotherapy; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012074:Remission Induction; D056910:Republic of Korea; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D011619:Psychotropic Drugs
keywords: bipolar disorder; maintenance treatment; recovery