Changes in mood stabilizer prescription patterns in bipolar disorder

- We studied prescription drug trends in bipolar disorder 2007-2013.
- Lithium prescription decreased in both bipolar disorder type I and II.
- The use of lamotrigine and quetiapine increased in both bipolar subtypes.
- Valproate use decreased in bipolar II disorder, and olanzapine use decreased in women.
- The prescription of antidepressants increased somewhat but only in bipolar I disorder.

BackgroundLithium is a first line treatment option in bipolar disorder, but several alternative treatments have been introduced in recent years, such as antiepileptic and atypical antipsychotic drugs. Little is known about how this has changed the prescription patterns. We investigated possible changes in the use of mood stabilizers and antidepressants in Sweden during 2007-2013.MethodsData was collected from Swedish registers: the National Quality Assurance Register for bipolar disorder (BipoläR), the Prescribed Drug Register, and the Patient Register. Logistic regression models with drug use as outcomes were used to adjust for confounding factors such as sex, age, year of registration, and subtypes of bipolar disorder.ResultsIn both bipolar subtypes, lithium use decreased steadily during the study period, while the use of lamotrigine and quetiapine increased. The use of valproate decreased in bipolar II disorder and the use of olanzapine decreased among women. The use of antidepressant remained principally unchanged but increased somewhat in bipolar I disorder.LimitationsWe only report data from 2007 as the coverage of BipoläR prior to 2007 was too low to allow for reliable analyses.ConclusionSignificant changes in the prescription of drugs in the treatment of bipolar disorder have occurred in recent years in Sweden. Further studies are needed to clarify whether these changes alter the outcome in bipolar disorder.