Kessing Lars Vedel, Vradi Eleni, Andersen Per Kragh
Psychiatric Center Copenhagen, Department O, Copenhagen, Denmark.
Faculty of Health and Medical Sciences, Copenhagen, Denmark.
Bipolar Disord. 2016 Mar;18(2):174-82. doi: 10.1111/bdi.12371. Epub 2016 Feb 18.
The aim of the present study was to describe prescription patterns and changes in these patterns over the last decade for patients diagnosed with bipolar disorder in mental healthcare, using population-based and nationwide data, and to relate the findings to recommendations from international guidelines.
A population-based, nationwide study was carried out. It included register-based longitudinal data on all patients with a first-ever contact with mental healthcare with a diagnosis of mania/bipolar disorder from the entire Danish population, and all prescription data for this population during the decade from 2000 to 2011, inclusive.
A total of 3,205 patients were included in the study. Lithium was prescribed less, and antiepileptic and atypical antipsychotic agents were prescribed substantially more during the study period. Lithium went from being the first drug prescribed to being the last, and was replaced by atypical antipsychotic agents. Antiepileptic agents went from being the fourth to the second drug class prescribed, and the prescription of antidepressants was virtually unchanged, at a high level, during the decade (one-year value 40-60%). The prescription of lamotrigine and quetiapine increased substantially. Combination therapy increased for all drug combinations, except for lithium combined with antidepressants.
Major changes took place in drug prescriptions during the study period. The decrease in the use of lithium and the constant high use of antidepressants do not align with recommendations from international guidelines.
本研究旨在利用基于人群的全国性数据，描述精神卫生保健中被诊断为双相情感障碍患者的处方模式及其在过去十年中的变化，并将研究结果与国际指南的建议进行关联。
开展了一项基于人群的全国性研究。该研究纳入了丹麦全体人口中所有首次因躁狂/双相情感障碍诊断而接触精神卫生保健的患者的基于登记的纵向数据，以及该人群在2000年至2011年（含）这十年间的所有处方数据。
共有3205名患者纳入本研究。在研究期间，锂盐的处方量减少，而抗癫痫药和非典型抗精神病药的处方量大幅增加。锂盐从最初被处方的药物变为最后被处方的药物，并被非典型抗精神病药所取代。抗癫痫药从被处方的第四大类药物变为第二大类，在这十年间抗抑郁药的处方量基本未变，维持在较高水平（一年的数值为40%-60%）。拉莫三嗪和喹硫平的处方量大幅增加。除锂盐与抗抑郁药联合使用外，所有药物组合的联合治疗均有所增加。
在研究期间，药物处方发生了重大变化。锂盐使用量的减少以及抗抑郁药持续的高使用量与国际指南的建议不一致。
