title: Changes in mood stabilizer prescription patterns in bipolar disorder.
abstract: BACKGROUND
  Lithium is a first line treatment option in bipolar disorder, but several alternative treatments have been introduced in recent years, such as antiepileptic and atypical antipsychotic drugs. Little is known about how this has changed the prescription patterns. We investigated possible changes in the use of mood stabilizers and antidepressants in Sweden during 2007-2013.
  
  
  METHODS
  Data was collected from Swedish registers: the National Quality Assurance Register for bipolar disorder (BipoläR), the Prescribed Drug Register, and the Patient Register. Logistic regression models with drug use as outcomes were used to adjust for confounding factors such as sex, age, year of registration, and subtypes of bipolar disorder.
  
  
  RESULTS
  In both bipolar subtypes, lithium use decreased steadily during the study period, while the use of lamotrigine and quetiapine increased. The use of valproate decreased in bipolar II disorder and the use of olanzapine decreased among women. The use of antidepressant remained principally unchanged but increased somewhat in bipolar I disorder.
  
  
  CONCLUSIONS
  We only report data from 2007 as the coverage of BipoläR prior to 2007 was too low to allow for reliable analyses.
  
  
  CONCLUSIONS
  Significant changes in the prescription of drugs in the treatment of bipolar disorder have occurred in recent years in Sweden. Further studies are needed to clarify whether these changes alter the outcome in bipolar disorder.
authors: Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Electronic address: alina.karanti@vgregion.se.
authors: Alina
authors: A
authors: Karanti
authors: Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; National Quality Register for Bipolar Disorder (BipoläR), Sahlgrenska University Hospital, Gothenburg, Sweden.
authors: Mathias
authors: M
authors: Kardell
authors: National Quality Register for Bipolar Disorder (BipoläR), Sahlgrenska University Hospital, Gothenburg, Sweden.
authors: Ulrika
authors: U
authors: Lundberg
authors: Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; National Quality Register for Bipolar Disorder (BipoläR), Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
authors: Mikael
authors: M
authors: Landén
mesh_terms: D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008094:Lithium / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D000077152:Olanzapine; D013548:Sweden; D014635:Valproic Acid / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D001569:Benzodiazepines; D014635:Valproic Acid; D008094:Lithium; D000077152:Olanzapine
keywords: Antidepressants; Bipolar disorder; Lamotrigine; Lithium; Mood stabilizers; Quetiapine