Table 2.
Patterns of drug treatment at discharge among patients with bipolar mania cohort, 2006 to 2019.
| 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | 2012 | 2013 | |
|---|---|---|---|---|---|---|---|---|
| Any mood stabilizers, n (%) | 132 (86.8%) | 156 (95.1%) | 182 (92.4%) | 177 (88.1%) | 194 (92.4%) | 172 (91.0%) | 199 (90.5%) | 197 (93.4%) |
| Lithium, n (%) | 58 (38.2%) | 73 (44.5%) | 84 (42.6%) | 74 (36.8%) | 73 (34.8%) | 57 (30.2%) | 83 (37.7%) | 81 (38.4%) |
| Valproate, n (%) | 70 (46.1%) | 82 (50.0%) | 108 (54.8%) | 119 (59.2%) | 136 (64.8%) | 125 (66.1%) | 139 (63.2%) | 147 (69.7%) |
| Carbamazepine, n (%) | 12 (7.9%) | 12 (7.3%) | 11 (5.6%) | 6 (3.0%) | 10 (4.8%) | 6 (3.2%) | 12 (5.5%) | 9 (4.3%) |
| Any antipsychotics, n (%) | 132 (86.8%) | 141 (86.0%) | 177 (89.8%) | 191 (95.0%) | 183 (87.1%) | 168 (88.9%) | 198 (90.0%) | 194 (91.9%) |
| SGAs*, n (%) | 42 (27.6%) | 49 (29.9%) | 82 (41.6%) | 96 (47.8%) | 104 (49.5%) | 112 (59.3%) | 136 (61.8%) | 146 (69.2%) |
| FGAs†, n (%) | 95 (62.5%) | 101 (61.6%) | 116 (58.9%) | 120 (59.7%) | 101 (48.1%) | 80 (42.3%) | 85 (38.6%) | 71 (33.6%) |
| Monotherapy, n (%) | 37 (24.3%) | 30 (18.3%) | 33 (16.8%) | 4 (16.9%) | 37 (17.6%) | 37 (19.6%) | 42 (19.1%) | 29 (13.7%) |
| Lithium, n (%) | 3 (8.1%) | 9 (30.0%) | 9 (27.3%) | 5 (14.7%) | 6 (16.2%) | 1 (2.7%) | 6 (14.3%) | 0 (0.0%) |
| Valproate, n (%) | 10 (27.0%) | 11 (36.7%) | 8 (24.2%) | 4 (11.8%) | 14 (37.8%) | 18 (48.6%) | 15 (35.7%) | 15 (51.7%) |
| Carbamazepine, n (%) | 4 (10.8%) | 2 (6.7%) | 1 (3.0%) | 1 (2.9%) | 1 (2.7%) | 1 (2.7%) | 0 (0.0%) | 0 (0.0%) |
| Antipsychotics, n (%) | 20 (54.1%) | 8 (26.7%) | 15 (45.5%) | 24 (70.6%) | 16 (43.2%) | 17 (45.9%) | 21 (50.0%) | 14 (48.3%) |
| Simple polypharmacy‡, n (%) | 110 (72.4%) | 124 (75.6%) | 145 (73.6%) | 145 (72.1%) | 154 (73.3%) | 137 (72.5%) | 144 (65.5%) | 145 (68.7%) |
| 1 antipsychotic + 1 mood stabilizer | 107 (97.3%) | 123 (99.2%) | 143 (98.6%) | 145 (100%) | 148 (96.1%) | 136 (99.3%) | 143 (99.3%) | 143 (98.6%) |
| 2 different mood stabilizers | 3 (2.7%) | 1 (0.8%) | 2 (1.4%) | 0 (0.0%) | 6 (3.9%) | 1 (0.7%) | 1 (0.7%) | 2 (1.4%) |
| Complex polypharmacy§, n (%) | 5 (3.3%) | 10 (6.1%) | 19 (9.6%) | 22 (10.9%) | 19 (9.0%) | 15 (7.9%) | 34 (15.5%) | 37 (17.5%) |
| Patients discharged, n | 152 | 164 | 197 | 201 | 210 | 189 | 220 | 152 |
| 2014 | 2015 | 2016 | 2017 | 2018 | 2019 | z | P | |
| Any mood stabilizers, n (%) | 190 (92.7%) | 190 (90.0%) | 195 (89.9%) | 237 (87.8%) | 237 (86.8%) | 203 (86.0%) | 2.518 | .012 |
| Lithium, n (%) | 97 (47.3%) | 101 (47.9%) | 86 (39.6%) | 87 (32.2%) | 96 (35.2%) | 75 (31.8%) | 1.607 | .108 |
| Valproate, n (%) | 124 (60.5%) | 128 (60.7%) | 136 (62.7%) | 169 (62.6%) | 176 (64.5%) | 152 (64.4%) | 3.935 | <.001 |
| Carbamazepine, n (%) | 11 (5.4%) | 6 (2.8%) | 8 (3.7%) | 14 (5.2%) | 17 (6.2%) | 9 (3.8%) | 1.087 | .277 |
| Any antipsychotics, n (%) | 190 (92.7%) | 203 (96.2%) | 208 (95.9%) | 254 (94.1%) | 263 (96.3%) | 220 (93.2%) | 5.139 | <.001 |
| SGAs*, n (%) | 155 (75.6%) | 178 (84.4%) | 186 (85.7%) | 225 (83.3%) | 237 (86.8%) | 200 (84.7%) | 21.902 | <.001 |
| FGAs†, n (%) | 74 (36.1%) | 64 (30.3%) | 52 (24.0%) | 65 (24.1%) | 67 (24.5%) | 56 (23.7%) | 15.320 | <.001 |
| Monotherapy, n (%) | 23 (11.2%) | 29 (13.7%) | 31 (14.3%) | 45 (16.7%) | 42 (15.4%) | 44 (18.6%) | 1.872 | .061 |
| Lithium, n (%) | 4 (17.4%) | 4 (13.8%) | 5 (16.1%) | 4 (8.9%) | 2 (4.8%) | 6 (13.6%) | 1.899 | .058 |
| Valproate, n (%) | 4 (17.4%) | 3 (10.3%) | 4 (12.9%) | 6 (13.3%) | 4 (9.5%) | 4 (9.1%) | 4.065 | <.001 |
| Carbamazepine, n (%) | 0 (0.0%) | 1 (3.4%) | 0 (0.0%) | 2 (4.4%) | 0 (0.0%) | 1 (2.3%) | 2.219 | .026 |
| Antipsychotics, n (%) | 15 (65.2%) | 21 (72.4%) | 22 (71.0%) | 33 (73.3%) | 36 (85.7%) | 33 (75.0%) | 5.612 | <.001 |
| Simple polypharmacy‡, n (%) | 147 (71.7%) | 137 (64.9%) | 151 (69.6%) | 196 (72.6%) | 183 (67.0%) | 164 (69.5%) | 1.961 | .005 |
| 2 different mood stabilizers | 7 (4.8%) | 0 (0.0%) | 0 (0.0%) | 4 (2.0%) | 4 (2.2%) | 5 (3.0%) | 0.731 | .465 |
| 1 mood stabilizer + any antipsychotics | 140 (95.2%) | 137 (100%) | 151 (100%) | 192 (98.0%) | 179 (97.8%) | 159 (97.0%) | ||
| Complex polypharmacy‡, n (%) | 35 (17.1%) | 45 (21.3%) | 35 (16.1%) | 29 (10.7%) | 48 (17.6%) | 28 (11.9%) | 4.755 | <.001 |
| Patients discharged, n | 211 | 205 | 211 | 217 | 270 | 273 |
Bolded values are statistically significant.
*
SGAs = second-generation antipsychotics.
†
FGAs = first-generation antipsychotics.
‡
Simple polypharmacy was defined as being prescribed 2 different mood stabilizers (lithium, valproate, or carbamazepine) or a mood stabilizer + any antipsychotics at discharge.
‡ Complex polypharmacy was defined as being prescribed ≥ 3 bipolar drugs (lithium, valproate, carbamazepine, and any antipsychotic) at discharge.