Shinozaki Masataka, Yasui-Furukori Norio, Adachi Naoto, Ueda Hitoshi, Hongo Seiji, Azekawa Takaharu, Kubota Yukihisa, Katsumoto Eiichi, Edagawa Koji, Goto Eiichiro, Miki Kazuhira, Kato Masaki, Nakagawa Atsuo, Kikuchi Toshiaki, Tsuboi Takashi, Watanabe Koichiro, Shimoda Kazutaka, Yoshimura Reiji
Department of Psychiatry, Dokkyo Medical University School of Medicine, Japan.
Department of Psychiatry, Dokkyo Medical University School of Medicine, Japan.
Asian J Psychiatr. 2022 Jan;67:102935. doi: 10.1016/j.ajp.2021.102935. Epub 2021 Nov 23.
There is limited information available on the prescription of psychotropic agents to patients with bipolar I (BD-I) and bipolar II disorder (BD-II). The purpose of this study was to investigate the characteristics of drug therapy in BD-I and BD-II outpatients, particularly with regard to antidepressants.
In 2017, the MUlticenter treatment SUrvey for BIpolar disorder in Japanese psychiatric clinics (MUSUBI) study collected data on current mental status, medications, and other factors from 2774 outpatients with BD-I or BD-II.
There were significant differences in the rates of prescriptions for mood stabilizers, antipsychotics and antidepressants. Mood stabilizers and antipsychotics were prescribed at higher rates to patients with BD-I (mood stabilizers; BD-I 86.0%, BD-II 80.8%, p < 0.001; antipsychotics; BD-I 61.5%, BD-II 47.8%, p < 0.001), and antidepressants were prescribed at higher rates to patients with BD-II (BD-I 32.1%, BD-II 46.4%, p < 0.001). The most commonly prescribed antidepressants were escitalopram for patients with BD-I and duloxetine for patients with BD-II. Selective serotonin reuptake inhibitors (SSRIs) were the most common class of antidepressants prescribed to patients with BD. With regard to combination therapy, combinations containing antidepressants were often prescribed to patients with BD-II.
There was a difference in the prescription of psychotropic agents between patients with BD-I and BD-II. The outpatient prescriptions for BD in Japan were mood stabilizers and antipsychotics, which generally followed the guidelines. There is insufficient evidence regarding the effects of the prescribed antidepressants and the risk of manic episodes, and further evidence needs to be collected.
关于双相I型障碍（BD-I）和双相II型障碍（BD-II）患者精神药物处方的可用信息有限。本研究的目的是调查BD-I和BD-II门诊患者的药物治疗特征，尤其是关于抗抑郁药方面。
2017年，日本精神科诊所双相情感障碍多中心治疗调查（MUSUBI）研究收集了2774例BD-I或BD-II门诊患者的当前精神状态、用药情况及其他因素的数据。
心境稳定剂、抗精神病药物和抗抑郁药的处方率存在显著差异。BD-I患者使用心境稳定剂和抗精神病药物的处方率更高（心境稳定剂；BD-I为86.0%，BD-II为80.8%，p<0.001；抗精神病药物；BD-I为61.5%，BD-II为47.8%，p<0.001），而BD-II患者使用抗抑郁药的处方率更高（BD-I为32.1%，BD-II为46.4%，p<0.001）。BD-I患者最常处方的抗抑郁药是艾司西酞普兰，BD-II患者是度洛西汀。选择性5-羟色胺再摄取抑制剂（SSRIs）是给BD患者处方最多的一类抗抑郁药。关于联合治疗，含抗抑郁药的联合处方常用于BD-II患者。
BD-I和BD-II患者在精神药物处方方面存在差异。日本BD门诊患者的处方药物是心境稳定剂和抗精神病药物，总体上遵循指南。关于所开抗抑郁药的疗效和躁狂发作风险的证据不足，需要收集更多证据。
