ArticleThe British journal of psychiatry : the journal of mental science2023
Real-world effectiveness of pharmacological treatments for bipolar disorder: register-based national cohort study.
Article in The British journal of psychiatry : the journal of mental science, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- Towards a Safe and Effective Lithium Therapeutic Range for Older Adults With Bipolar Disorder: An ISBD Task Force Systematic Review.Bipolar disorders · 2026Pooled it
- A critical review of the early clozapine trials published in German and a discussion of the many unresolved issues left by these trials.Naunyn-Schmiedeberg's archives of pharmacology · 2026Review
- Association between maintenance doses of mood stabilizers and antipsychotics and risk of readmission in first-episode bipolar disorder.Molecular psychiatry · 2026Article
- Article
- A Multicentre, 4-Year Mirror-Image Study Comparing the Effectiveness of Long-Acting Injectable Antipsychotics in the Treatment of Bipolar Disorder: Results From the LAICO Study.Bipolar disorders · 2026Article
- Patient experiences with brainInternational journal of bipolar disorders · 2026Article
- Relapse risk prediction in patients with first-episode bipolar disorder: development, external validation, and pharmacotherapy associations of a machine learning model.Molecular psychiatry · 2025Article
- Prescribing lithium for the management of persons suffering from bipolar disorders: expert consensus based on a Delphi study.International journal of bipolar disorders · 2025Article
- Global Trends in the Use of Pharmacotherapy for the Treatment of Bipolar Disorder.Current psychiatry reports · 2025Review
- Comprehensive bibliometric analysis of pharmacotherapy for bipolar disorders: Present trends and future directions.World journal of psychiatry · 2025Article
- Mapping review of register-based cohort studies of bipolar disorder.Bipolar disorders · 2024Review
- Aripiprazole once-monthly for the treatment of adult patients with earlier-stage bipolar I disorder: a post hoc analysis of data from a double-blind, placebo-controlled, 52-week randomized withdrawal trial.International journal of bipolar disorders · 2024Article
- Real-world effectiveness of antidepressants, antipsychotics and their combinations in the maintenance treatment of psychotic depression. Evidence from within-subject analyses of two nationwide cohorts.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2024Article
- Effectiveness of ultra-long-term lithium treatment: relevant factors and case series.International journal of bipolar disorders · 2024Review
- International Trends in Lithium Use for Pharmacotherapy and Clinical Correlates in Bipolar Disorder: A Scoping Review.Brain sciences · 2024Article
- Why is lithium [not] the drug of choice for bipolar disorder? a controversy between science and clinical practice.International journal of bipolar disorders · 2024Review
- Lithium prescription trends in psychiatric inpatient care 2014 to 2021: data from a Bavarian drug surveillance project.International journal of bipolar disorders · 2023Article
- Letter to the FDA Proposing Major Changes in the US Clozapine Package Insert Supported by Clozapine Experts Worldwide. Part II: A Review of Fatal Outcomes in US Pharmacovigilance Data and Proposed Changes.Journal of clinical psychopharmacologyArticle
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPharmacological treatment patterns for bipolar disorder have changed during recent years, but for better or worse?
aimsTo investigate the comparative real-world effectiveness of antipsychotics and mood stabilisers in bipolar disorder.
methodRegister-based cohort study including all Finnish residents aged 16-65 with a diagnosis of bipolar disorder from in-patient care, specialised out-patient care, sickness absence and disability pensions registers between 1996 and 2018, with a mean follow-up of 9.3 years (s.d. = 6.4). Antipsychotic and mood stabiliser use was modelled using the PRE2DUP method and risk for hospital admission for psychiatric and non-psychiatric reasons when using versus not using medications was estimated using within-individual Cox models.
resultsAmong 60 045 individuals (56.4% female; mean age 41.7 years, s.d. = 15.8), the five medications associated with lowest risk of psychiatric admissions were olanzapine long-acting injection (LAI) (aHR = 0.54, 95% CI 0.37-0.80), haloperidol LAI (aHR = 0.62, 0.47-0.81), zuclopenthixol LAI (aHR = 0.66, 95% CI 0.52-0.85), lithium (aHR = 0.74, 95% CI 0.71-0.76) and clozapine (aHR = 0.75, 95% CI 0.64-0.87). Only ziprasidone (aHR = 1.26, 95% CI 1.07-1.49) was associated with a statistically higher risk. For non-psychiatric (somatic) admissions, only lithium (aHR = 0.77, 95% CI 0.74-0.81) and carbamazepine (aHR = 0.91, 95% CI 0.85-0.97) were associated with significantly reduced risk, whereas pregabalin, gabapentin and several oral antipsychotics, including quetiapine, were associated with an increased risk. Results for a subcohort of first-episode patients (26 395 individuals, 54.9% female; mean age 38.2 years, s.d. = 13.0) were in line with those of the total cohort.
conclusionsLithium and certain LAI antipsychotics were associated with lowest risks of psychiatric admission. Lithium was the only treatment associated with decreased risk of both psychiatric and somatic admissions.
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