title: [Prescribed drug use for bipolar disorder type I and II in clinical practice].
abstract: Prescribed drug use for bipolar disorder type I and II in clinical practice Practice guidelines based on available evidence and clinical consensus are available for the treatment of bipolar disorder. We surveyed to which extent those guidelines are implemented in clinical practice in Sweden. We analysed pharmacological treatment in patients with bipolar disorder in 2015 using the national quality register for bipolar disorder (BipoläR). We compared bipolar disorder type I (BDI) with type bipolar disorder type II (BDII). The vast majority of patients were prescribed a mood stabilizer either as monotherapy or as a part of combination therapy (BDI 87%, BDII 83%, p<0.001). Whereas lithium was the most common mood stabilizer in type I (BDI 65%, BDII 40%, p<0.001), lamotrigine was the most common mood stabilizer in type II (BDI 18%, BDII 42%, p<0.001). Antidepressants were less common in BDI than BDII (35% vs. 53%, p<0.001). Antipsychotic drugs (first or second generation) were more frequently used in BDI than BDII (49% vs 35%, p<0.001). Central stimulants were rarely used (BDI 3.1%, BDII 6.6%, p<0.001). Combining a mood stabilizer with an antipsychotic drug was more common in BDI than BDII (27% vs. 12%, p<0.001), whereas combining a mood stabilizer with an antidepressant was less common in BDI than BDII (16% vs 28%, p<0.001). We conclude that most patients are prescribed mood stabilizers and that the differences between BDI and BDII are rational given the differences in clinical manifestations. The use of antidepressants is surprisingly high given the long-standing debate about the risk and effectiveness of this class in bipolar disorder.
authors.affiliation: Sahlgrenska universitetssjukhuset - Psykiatri Psykos Göteborg, Sweden Sahlgrenska universitetssjukhuset - Psykiatri Psykos Göteborg, Sweden.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Persson
authors.affiliation: BipoläR- Nationella kvalitetsregistret för bipolär affektiv sjukdom - Göteborgs universitet Göteborg, Sweden National Quality Register for bipolar disorder BipoläR - University of Gothenburg Gothenburg, Sweden.
authors.forename: Mathias
authors.initials: M
authors.lastname: Kardell
authors.affiliation: Institutionen för neurovetenskap och fysiologi, Göteborgs universitet - Sektionen för psykiatri och neurokemi Göteborg, Sweden Neuroscience and Physiology - Psychiatry and Neurochemistry, University of Gothenburg Gothenburg, Sweden.
authors.forename: Alina
authors.initials: A
authors.lastname: Karanti
authors.affiliation: Sahlgrenska akademin vid Göteborgs universitet - Institutionen för neurovetenskap och fysiologi Göteborg, Sweden Sahlgrenska akademin vid Göteborgs universitet - Institutionen för neurovetenskap och fysiologi Göteborg, Sweden.
authors.forename: Anniella
authors.initials: A
authors.lastname: Isgren
authors.affiliation: Sahlgrenska akademin vid Göteborgs universitet - Institutionen för neurovetenskap och fysiologi Göteborg, Sweden Sahlgrenska akademin vid Göteborgs universitet - Institutionen för neurovetenskap och fysiologi Göteborg, Sweden.
authors.forename: Kristina
authors.initials: K
authors.lastname: Annerbrink
authors.affiliation: Institutionen för neurovetenskap och fysiologi, Göteborgs universitet - Sektionen för psykiatri och neurokemi Göteborg, Sweden Institutionen för neurovetenskap och fysiologi, Göteborgs universitet - Sektionen för psykiatri och neurokemi Göteborg, Sweden.
authors.forename: Mikael
authors.initials: M
authors.lastname: Landen
mesh_terms: D000928:Antidepressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D018692:Antimanic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001569:Benzodiazepines / Q000008:administration & dosage / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy*; D011307:Drug Prescriptions; D004359:Drug Therapy, Combination; D019983:Guideline Adherence; D006801:Humans; D017410:Practice Guidelines as Topic; D012042:Registries
chemical_list: D000928:Antidepressive Agents; D018692:Antimanic Agents; D014150:Antipsychotic Agents; D001569:Benzodiazepines