Karanti Alina, Kardell Mathias, Lundberg Ulrika, Landén Mikael
Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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.
J Affect Disord. 2016 May;195:50-6. doi: 10.1016/j.jad.2016.01.043. Epub 2016 Feb 2.
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.
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.
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.
We only report data from 2007 as the coverage of BipoläR prior to 2007 was too low to allow for reliable analyses.
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.
锂盐是双相情感障碍的一线治疗选择，但近年来已引入了几种替代治疗方法，如抗癫痫药和非典型抗精神病药物。对于这如何改变处方模式知之甚少。我们调查了2007 - 2013年期间瑞典心境稳定剂和抗抑郁药使用情况的可能变化。
数据从瑞典登记处收集：双相情感障碍国家质量保证登记处（BipoläR）、处方药登记处和患者登记处。以药物使用情况为结果的逻辑回归模型用于调整混杂因素，如性别、年龄、登记年份和双相情感障碍的亚型。
在两种双相情感障碍亚型中，在研究期间锂盐的使用稳步下降，而拉莫三嗪和喹硫平的使用增加。丙戊酸盐在双相II型障碍中的使用减少，奥氮平在女性中的使用减少。抗抑郁药的使用基本保持不变，但在双相I型障碍中略有增加。
我们仅报告了2007年的数据，因为2007年之前BipoläR的覆盖范围过低，无法进行可靠分析。
近年来瑞典在双相情感障碍治疗的药物处方方面发生了显著变化。需要进一步研究以阐明这些变化是否会改变双相情感障碍的治疗结果。
