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Antipsychotic use patterns in persons initially treated with mood stabilizers: a naturalistic study.
H Verdoux1, A Cougnard, G-R Auleley
1INSERM U657, Université Victor Segalen, Bordeaux 2, France. helene.verdoux@u-bordeaux2.fr
Pharmacopsychiatry
|February 24, 2010
Summary
Antipsychotic use in patients on mood stabilizers is common, with second-generation antipsychotics (SGAPs) often added. Most patients eventually stop mood stabilizers when switching to antipsychotics.
Area of Science:
- Psychiatry and Pharmacology
Background:
- Limited data exists on antipsychotic prescribing patterns in real-world settings for patients on conventional mood stabilizers.
- Understanding these patterns is crucial for optimizing treatment strategies.
Purpose of the Study:
- To investigate the patterns of antipsychotic use in individuals initially treated with mood stabilizers (lithium and anticonvulsants).
- To analyze whether second-generation antipsychotics (SGAPs) or first-generation antipsychotics (FGAPs) are preferentially used.
Main Methods:
- Analysis of community prescription data from a French health insurance database (2004-2006).
- Inclusion of patients continuously exposed to mood stabilizers without antipsychotics for at least three months.
- Tracking of antipsychotic addition or switching events.
Main Results:
- 17.8% of 3,958 patients had antipsychotics added or switched during follow-up.
- Addition of SGAPs (41%) or FGAPs (23%) to mood stabilizers was most common.
- Switching from mood stabilizers to SGAPs (20%) or FGAPs (15%) was less frequent.
- Most patients continued mood stabilizers when SGAPs/FGAPs were added, but often continued antipsychotics after switching.
Conclusions:
- Second-generation antipsychotics are frequently prescribed in combination with mood stabilizers.
- The prescribing patterns for SGAPs are similar to those observed for FGAPs in this population.
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