ArticleInternational journal of bipolar disorders2025
Twenty-four years of prescription patterns in bipolar disorder inpatients with vs without lithium: a pharmacoepidemiological analysis of 8,707 cases in German-speaking countries.
Article in International journal of bipolar disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Trajectories of psychotropic drug use patterns in psychiatric inpatients with acute depressive episodes of bipolar disorder: results from a pharmacovigilance program in German-speaking countries from 2007 to 2024.International journal of bipolar disorders · 2026Article
- Understanding Antipsychotic Polypharmacy in Bipolar Disorder: The Role of Long-Acting Injectable Antipsychotics in a Naturalistic Inpatient Setting.The Psychiatric quarterly · 2026Article
- Adult psychiatrists' views on clozapine prescribing for schizophrenia in Germany-an online survey.Therapeutic advances in psychopharmacology · 2026Article
- At 75 Years, Is Lithium the Gold Standard in Bipolar Disorder?Pharmaceuticals (Basel, Switzerland) · 2025Review
- Evidence of lithium underuse in bipolar disorder: analysis of lithium and antipsychotic consumption, prediction of future trends, regional disparities and indicators of rational and inappropriate use in Europe.Naunyn-Schmiedeberg's archives of pharmacology · 2025Article
- [Lithium treatment and reduction of suicide risk: evidence and clinical significance].Der Nervenarzt · 2025Review
- Lamotrigine Therapy: Relation Between Treatment of Bipolar Affective Disorder and Incidence of Stevens-Johnson Syndrome-A Narrative Review of the Existing Literature.Journal of clinical medicine · 2025Review
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Authors and funding
10 authors.
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Abstract
backgroundGlobal pharmacoepidemiological evidence suggests dynamically changing prescription patterns in patients with bipolar disorders. We assessed trends in the use of pharmacological agents used in the management of bipolar disorders in inpatients.
methodsWe examined drug use data provided by the Drug Safety in Psychiatry Programme AMSP (German: "Arzneimittelsicherheit in der Psychiatrie"), including psychiatric hospitals in Germany, Austria and Switzerland. We included data from adult inpatients with bipolar disorders (ICD-10: F31) treated between 1994 and 2017. We compared prescription patterns between patients receiving therapeutic regimens with vs. without lithium. Patients with manic and depressive episodes were also analyzed separately.
resultsWe identified a total of 8,707 patients (58% females, mean age 50.8 ± 14.8 years). Our analysis revealed a decrease of lithium use (up to 2004) and a consistent increase of prescription rates for second-generation antipsychotics (SGA) among which quetiapine (n = 2,677) and olanzapine (n = 1,536) were the most common. Among psychotropic drugs, quetiapine was most frequently combined with lithium (n = 716, 25.6%). Lithium-treated patients received a higher number of drugs compared to patients not receiving lithium (mean number of drugs in patients with vs. without lithium 4.99, n = 2,796 vs. 4.75, n = 5,911, p = 0.002). Thyroid therapeutics were given more often, valproate and quetiapine less often in the lithium group. Antidepressants were consistently prescribed to more than 60% of patients with bipolar depressive episodes.
conclusionsOur findings suggest that SGAs are gradually becoming the mainstay treatment option in bipolar disorder, continuously replacing lithium. The use of antidepressants remains concerningly high. We call for action to improve adherence to evidence-based guidelines.
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