Por favor, use este identificador para citar o enlazar este ítem: http://conacyt.repositorioinstitucional.mx/jspui/handle/1000/283
Trends in Prescriptions of Lithium and Other Medications for Patients with Bipolar Disorder in Office-based Practices in the United States: 1996-2015
Yian Lin
Ramin Mojtabai
Fernando S Goes
Peter P Zandi
Novel Coronavirus
Acceso Abierto
Atribución-SinDerivadas
10.1101/2020.01.18.20018028
Background Studies have shown that rates of lithium use for bipolar disorder (BPD) in the United States declined through the 1990s as other mood stabilizing anticonvulsants and second-generation antipsychotics (SGAs) became more popular. We examined recent prescribing trends of medications for BPD over the past two decades. Methods Twenty years of data (1996-2015) from the National Ambulatory Medical Care Survey (NAMCS) were used. Weighted percentages of prescriptions of lithium, anticonvulsants, SGAs and antidepressants were calculated over two-year intervals. Logistic regression was used to examine factors related to polytherapy. Results Prescriptions of lithium declined from 38.1% (95%CI: 29.8% - 46.3%) in 1996-97 to 14.3% (95%CI: 10.6% - 18.1%) in 2006-07 and has remained stable since. During this time, prescriptions of SGAs more than doubled. SGAs and/or anticonvulsants were prescribed in 78.6% (95%CI: 73.0% - 84.2%) of BPD visits in 2014-2015. Polytherapy increased by approximately 4% every two years and in 2014-15 occurred in over 35% of BPD visits. Antidepressants were prescribed in 40-50% of BPD visits, but their prescriptions without other mood stabilizers decreased from 18.2% (95%CI: 11.7% - 24.8%) in 1998-99 to 5.8% (95%CI: 3.0% - 8.6%) in 2014-15. Limitations The sample had limited power to study the effect of individual medications or the potential for differing effects in certain subgroups of patients. Conclusions This study further documents the declining prescriptions of lithium for BPD, and corresponding increase in prescriptions of anticonvulsants and SGAs, despite the fact that lithium is typically recommended as a first line therapy for BPD. ### Competing Interest Statement Fernando S. Goes has received research support from Janssen Pharmaceuticals. ### Funding Statement No external funding was received. ### Author Declarations All relevant ethical guidelines have been followed; any necessary IRB and/or ethics committee approvals have been obtained and details of the IRB/oversight body are included in the manuscript. Yes All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes NAMCS data are publicly available through CDC.
Cold Spring Harbor Laboratory Press
2020
Preimpreso
https://www.medrxiv.org/content/10.1101/2020.01.18.20018028v1
Inglés
VIRUS RESPIRATORIOS
Aparece en las colecciones: Artículos científicos

Cargar archivos:


Fichero Tamaño Formato  
Trends in prescriptions.pdf367.1 kBAdobe PDFVisualizar/Abrir