title: Gender differences in mood stabilizer medications prescribed to Veterans with serious mental illness.
abstract: BACKGROUND
  Mood stabilizer medications (MSMs) can induce significant weight gain and other metabolic side effects. Research suggests that women are more susceptible to psychotropic medication-induced metabolic side effects than men. We examined gender differences in the likelihood of receiving an MSM with a lower liability for weight gain using data from the U.S. Department of Veterans Affairs (VA) healthcare system.
  
  
  METHODS
  We identified 3823 VA patients with a schizophrenia or bipolar disorder diagnosis who initiated treatment with a MSM between 10/2006 and 9/2011. We used multivariable logistic regression analysis to examine gender differences in the likelihood of incident prescription of MSMs with low versus medium/high metabolic risk, adjusting for fiscal year of prescribing and demographic, mental health, and physical health characteristics.
  
  
  RESULTS
  Overall, 47% of women were prescribed a low metabolic risk MSM compared to 26% of men (p<0.0001). In multivariable analysis, women were 2.19 times as likely as men to be prescribed a low metabolic risk MSM (95% CI: 1.84-2.60, p<0.0001). Several demographic and clinical covariates were also independently related to prescribing of MSMs by level of metabolic risk.
  
  
  CONCLUSIONS
  This study used retrospective administrative data collected from a VA healthcare system database, which does not allow us to understand the context in which MSM treatment decisions were made.
  
  
  CONCLUSIONS
  Prescribing choices for MSMs by VA mental health prescribers and female Veterans may reflect a growing awareness of the potential adverse health consequences of these treatments in women.
authors.affiliation: University of Maryland School of Medicine, Department of Psychiatry, Division of Psychiatric Services Research, Baltimore, MD, United States. Electronic address: Mcharlot@psych.umaryland.edu.
authors.forename: Melanie
authors.initials: M
authors.lastname: Charlotte
authors.affiliation: VA Capitol Healthcare Network (VISN 5) Mental Illness Research, Education, and Clinical Center (MIRECC), Baltimore, MD, United States.
authors.forename: Elana
authors.initials: E
authors.lastname: Schwartz
authors.affiliation: University of Maryland School of Medicine, Department of Psychiatry, Division of Psychiatric Services Research, Baltimore, MD, United States; VA Capitol Healthcare Network (VISN 5) Mental Illness Research, Education, and Clinical Center (MIRECC), Baltimore, MD, United States.
authors.forename: Eric
authors.initials: E
authors.lastname: Slade
authors.affiliation: University of Maryland School of Medicine, Department of Psychiatry, Division of Psychiatric Services Research, Baltimore, MD, United States; VA Capitol Healthcare Network (VISN 5) Mental Illness Research, Education, and Clinical Center (MIRECC), Baltimore, MD, United States.
authors.forename: Deborah
authors.initials: D
authors.lastname: Medoff
authors.affiliation: University of Maryland School of Medicine, Department of Psychiatry, Division of Psychiatric Services Research, Baltimore, MD, United States.
authors.forename: Lan
authors.initials: L
authors.lastname: Li
authors.affiliation: Center for Practice Innovations, New York State Psychiatric Institute, Department of Psychiatry, Columbia University, New York, NY, United States.
authors.forename: Lisa
authors.initials: L
authors.lastname: Dixon
authors.affiliation: Quality Enhancement Research Initiative, VA Health Services Research and Development (HSR&D Program), Washington DC, United States; Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States.
authors.forename: Amy M
authors.initials: AM
authors.lastname: Kilbourne
authors.affiliation: University of Maryland School of Medicine, Department of Psychiatry, Division of Psychiatric Services Research, Baltimore, MD, United States; VA Capitol Healthcare Network (VISN 5) Mental Illness Research, Education, and Clinical Center (MIRECC), Baltimore, MD, United States.
authors.forename: Julie
authors.initials: J
authors.lastname: Kreyenbuhl
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy*; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000139:chemically induced / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors; D012559:Schizophrenia / Q000188:drug therapy*; D012727:Sex Characteristics; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*; D015430:Weight Gain / Q000187:drug effects*
chemical_list: D014150:Antipsychotic Agents
keywords: Mood stabilizer medications; Serious mental illness; Weight gain; Women