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Neuroleptics in acute mania: a pharmacoepidemiologic study
The Annals of Pharmacotherapy
|December 1, 1996
Summary
In 1990, neuroleptics were the standard acute treatment for bipolar mania in New York State psychiatric facilities, despite recommendations against their use for mood disorders. Other medications like lithium and anticonvulsants were also used.
Area of Science:
- Psychiatry
- Pharmacology
- Epidemiology
Background:
- Bipolar mania requires effective acute drug treatment.
- The use of neuroleptics for mood disorders has been debated.
- Understanding treatment patterns is crucial for patient care.
Purpose of the Study:
- To describe the acute drug treatment of inpatients with bipolar mania.
- To analyze treatment patterns in New York State psychiatric facilities in 1990.
Main Methods:
- Descriptive epidemiologic analysis.
- Survey of the first 3 weeks of drug treatment for 528 inpatients with bipolar mania.
- Data collected from 22 New York State adult psychiatric facilities.
Main Results:
- Neuroleptics were the primary acute treatment for mania (almost all patients).
- Mean neuroleptic dosage was 684 +/- 543 mg/d chlorpromazine equivalents.
- 61% received lithium; 12% received carbamazepine or valproate. Older patients received lower neuroleptic doses.
Conclusions:
- Neuroleptics remained the standard acute treatment for mania in 1990.
- Combination treatments did not significantly alter mean neuroleptic dosage.
- Treatment patterns in 1990 contrast with later recommendations.