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Factors Associated with Doses of Mood Stabilizers in Real-world Outpatients with Bipolar Disorder

Clinical Psychopharmacology and Neuroscience 2020년 18권 4호 p.599 ~ 606
Yasui-Furukori Norio, Adachi Naoto, Kubota Yukihisa, Azekawa Takaharu, Goto Eiichiro, Edagawa Koji, Katsumoto Eiichi, Hongo Seiji, Ueda Hitoshi, Miki Kazuhira, Kato Masaki, Yoshimura Reiji, Nakagawa Atsuo, Kikuchi Toshiaki, Tsuboi Takashi, Watanabe Koichiro, Shimoda Kazutaka,
소속 상세정보
 ( Yasui-Furukori Norio ) - Dokkyo Medical University School of Medicine Department of Psychiatry
 ( Adachi Naoto ) - Japanese Association of Neuro-Psychiatric Clinics
 ( Kubota Yukihisa ) - Japanese Association of Neuro-Psychiatric Clinics
 ( Azekawa Takaharu ) - Japanese Association of Neuro-Psychiatric Clinics
 ( Goto Eiichiro ) - Japanese Association of Neuro-Psychiatric Clinics
 ( Edagawa Koji ) - Japanese Association of Neuro-Psychiatric Clinics
 ( Katsumoto Eiichi ) - Japanese Association of Neuro-Psychiatric Clinics
 ( Hongo Seiji ) - Japanese Association of Neuro-Psychiatric Clinics
 ( Ueda Hitoshi ) - Japanese Association of Neuro-Psychiatric Clinics
 ( Miki Kazuhira ) - Japanese Association of Neuro-Psychiatric Clinics
 ( Kato Masaki ) - Japanese Society of Clinical Neuropsychopharmacology
 ( Yoshimura Reiji ) - University of Occupational and Environmental Health Department of Psychiatry
 ( Nakagawa Atsuo ) - Japanese Society of Clinical Neuropsychopharmacology
 ( Kikuchi Toshiaki ) - Japanese Society of Clinical Neuropsychopharmacology
 ( Tsuboi Takashi ) - Japanese Society of Clinical Neuropsychopharmacology
 ( Watanabe Koichiro ) - Japanese Society of Clinical Neuropsychopharmacology
 ( Shimoda Kazutaka ) - Dokkyo Medical University School of Medicine Department of Psychiatry

Abstract


Objective: Several evidence-based practice guidelines have been developed to better treat bipolar disorder. However, the articles cited in these guidelines were based on clinical or basic studies with specific conditional settings and were not sufficiently based on real-world clinical practice. In particular, there was little information on the doses of mood stabilizers.

Methods: The MUlticenter treatment SUrvey on BIpolar disorder in Japanese psychiatric clinics (MUSUBI) is a study conducted to accumulate evidence on the real-world practical treatment of bipolar disorder. The questionnaire included patient characteristics such as comorbidities, mental status, treatment period, Global Assessment of Functioning (GAF) score, and details of pharmacological treatment.

Results: Most patients received mood stabilizers such as lithium (n = 1,317), valproic acid (n = 808), carbamazepine (n = 136), and lamotrigine (n = 665). The dose of lithium was correlated with age, body weight, number of episodes, depression and GAF. The dose of valproic acid was correlated with body weight, number of episodes, presence of a rapid cycle and GAF. The dose of carbamazepine was correlated with age, mania, and the presence of a rapid cycle. The dose of lamotrigine was correlated with the number of episodes, depression, mania, psychotic features, and the presence of a rapid cycle. Doses of coadministered mood stabilizers were significantly correlated, except for the combination of valproic acid and lamotrigine.

Conclusion: The dose of mood stabilizers was selectively administered based on several factors, such as age, body composition, current mood status and functioning. Further prospective studies are required to confirm these findings.

키워드

Bipolar disorder; Mood stabilizers; Nationwide study; Real world; Dose

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