Comparison of psychodrug prescription patterns in patients diagnosed with bipolar disorder and addiction

To describe if there are differences in the prescription of psychodrug at discharge between bipolar disorder patients with or without addiction.

We review all the psychotropic drugs dispensed to inpatients of a brief hospitalization psychiatric unit diagnosed as having bipolar disorder at time of discharge. We recluted 225 patients over 18 years old on their last manic episode, between the year 2000 and 2010. We classify them according to the comorbid presence or not of a substance abuse or dependence disorder.

Prevalence of addiction was 24%. We found no differences between groups in the number of psychotropic drugs prescribed at discharge. The prescription pattern of mood stabilizers and benzodiazepines was similar in both groups. We detect differences in the total daily dose of antipsychotic, expressed as risperidone equivalents (5.86 ± 4.62 mg in addictions group versus 4.67 ± 3.20 mg in control group, p=0.042) and in the total daily dose of biperideno (4.80 ± 1.78 mg in addictions group versus 3.20 ± 1.03 mg in the control group, p=0.044).

Contrary to our expectations, both groups were similar in psychopharmacological prescription patterns at discharge. However, those patients with substance abuse disorder had higher doses of antipsychotics and higher dose biperiden at discharge.