Factors associated with maintenance antipsychotic treatment of patients with bipolar disorder

Although recent surveys suggest that a substantial number of patients with bipolar disorder receive maintenance treatment with antipsychotic agents, little is known about the clinical factors associated with such treatment in this patient population. The purpose of this study was to identify clinical factors associated with maintenance antipsychotic treatment in patients with bipolar disorder.

Seventy-seven patients who had bipolar disorder and were hospitalized for acute manic or mixed episodes were evaluated according to demographic, diagnostic, illness severity, treatment, and compliance variables at admission and at follow-up 6 months after discharge to determine differences between patients receiving ongoing antipsychotic medications and those maintained on thymoleptics alone.

Fifty-two patients (68%) continued to receive antipsychotics 6 months after discharge. Maintenance antipsychotic treatment at 6-month follow-up was associated with being male, medication noncompliance in the month prior to the index hospitalization, severity of manic symptoms, and prescription of antipsychotic medication at time of discharge.

Despite the risks of neurologic and behavioral side effects associated with protracted antipsychotic treatment and the availability of agents with mood-stabilizing properties such as lithium, valproate, and carbamazepine, antipsychotic maintenance treatment of bipolar disorder is common and associated with several important clinical factors.