Comparison and Assessment of Prescribing Pattern of Psychotropic Agents in Bipolar Affective Disorder with Mania and Depression

Authors

  • AJMAL SHAJAHAN Doctor of pharmacy intern, Indiana hospital and heart institute, Pumpwell, Mangalore, Karnataka
  • Angel Princy K R Doctor of pharmacy intern, Indiana hospital and heart institute, Pumpwell, Mangalore, Karnataka
  • Mahima M S Doctor of pharmacy intern, Indiana hospital and heart institute, Pumpwell, Mangalore, Karnataka
  • Muhammed Safwan Doctor of pharmacy intern, Indiana hospital and heart institute, Pumpwell, Mangalore, Karnataka
  • Fathima Jaleela M A Associate professor, Department of pharmacy practice, Shree Devi College Of Pharmacy, Kenjar Airport Road, Dakshina Kannada, Mangalore, Karnataka – 574142

Abstract

INTRODUCTION:  Bipolar disorder is a recurring chronic disorder characterized by mood, state, and energy fluctuations. Individuals differ in symptoms, course, severity, and response to treatment. It is critical to know the current knowledge of the evolving pharmacological and psychological strategies in bipolar disorder.    

Primary Objective: To compare and assess the prescribing pattern of psychotropic agents in bipolar affective disorder with mania and depression in a tertiary care teaching hospital.

Secondary Objectives:

  • Determination of risk and cofactors associated with Bipolar Disorder
  • Assessment of treatment modalities

DESIGN: Prospective observational study

RESULTS: The most commonly prescribed drug combination was Mood stabilizer + Antipsychotics + Benzodiazepine combination, 5(33.3%) in bipolar depression and9(60.0%) in bipolar mania. A very small percentage of patients(6.7%) received ECT. The most commonly prescribed drug was valproic acid (Mood stabilizer), 7(46.7%) in bipolar depression and 14(93.3%) in bipolar mania.

CONCLUSION: According to the data, Mood stabilizers were found to be the most commonly prescribed drug. Combination treatments are prevalent, reflecting the complexity of managing bipolar disorder. Although various genetic and environmental risk factors are identified, the attributable risk of individual elements is often less.

KEYWORDS: Bipolar disorder, Mania, Depression, Valproic acid

Keywords:

Bipolar disorder, Depression, Mania

DOI

https://doi.org/10.22270/jddt.v12i5-S.5702

Author Biographies

AJMAL SHAJAHAN, Doctor of pharmacy intern, Indiana hospital and heart institute, Pumpwell, Mangalore, Karnataka

Doctor of pharmacy intern, Indiana hospital and heart institute, Pumpwell, Mangalore, Karnataka

Angel Princy K R, Doctor of pharmacy intern, Indiana hospital and heart institute, Pumpwell, Mangalore, Karnataka

Doctor of pharmacy intern, Indiana hospital and heart institute, Pumpwell, Mangalore, Karnataka

Mahima M S, Doctor of pharmacy intern, Indiana hospital and heart institute, Pumpwell, Mangalore, Karnataka

Doctor of pharmacy intern, Indiana hospital and heart institute, Pumpwell, Mangalore, Karnataka

Muhammed Safwan, Doctor of pharmacy intern, Indiana hospital and heart institute, Pumpwell, Mangalore, Karnataka

Doctor of pharmacy intern, Indiana hospital and heart institute, Pumpwell, Mangalore, Karnataka

Fathima Jaleela M A, Associate professor, Department of pharmacy practice, Shree Devi College Of Pharmacy, Kenjar Airport Road, Dakshina Kannada, Mangalore, Karnataka – 574142

Associate professor, Department of pharmacy practice, Shree Devi College Of Pharmacy, Kenjar Airport Road, Dakshina Kannada, Mangalore, Karnataka – 574142

References

Grande I, Berk M, Birmaher B, Vieta E. Bipolar disorder. The Lancet. 2016 Apr 9; 387(10027):1561-72. https://doi.org/10.1016/S0140-6736(15)00241-X

Tohen M, Vieta E, Calabrese J, Ketter TA, Sachs G, Bowden C, Mitchell PB, Centorrino F, Risser R, Baker RW, Evans AR. Efficacy of olanzapine and olanzapine-fluoxetine combination in the treatment of bipolar I depression. Archives of general psychiatry. 2003 Nov 1; 60(11):1079-88. https://doi.org/10.1001/archpsyc.60.11.1079

Malhi GS, Adams D, Lampe L, Paton M, O'connor N, Newton LA, Walter G, Taylor A, Porter R, Mulder RT, Berk M. Clinical practice recommendations for bipolar disorder. Acta Psychiatrica Scandinavica. 2009 May; 119:27-46 https://doi.org/10.1111/j.1600-0447.2009.01383.x

Belmaker RH. Bipolar Disorder. New England Journal of Medicine. 2004 Jul 29; 351(5):476-86. https://doi.org/10.1056/NEJMra035354

Phillips ML, Kupfer DJ. Bipolar disorder diagnosis: challenges and future directions. The Lancet. 2013 May 11; 381(9878):1663-71. https://doi.org/10.1016/S0140-6736(13)60989-7

Bauer M, Pfennig A. Epidemiology of bipolar disorders. Epilepsia. 2005 Jun; 46: 8-13. https://doi.org/10.1111/j.1528-1167.2005.463003.x

Anderson IM, Haddad PM, Scott J. Bipolar disorder. Bmj. 2012 Dec 27; 345. https://doi.org/10.1136/bmj.e8508

Müller-Oerlinghausen B, Berghöfer A, Bauer M. Bipolar disorder. The Lancet. 2002 Jan 19; 359(9302):241-7. https://doi.org/10.1016/S0140-6736(02)07450-0

Hilty DM, Leamon MH, Lim RF, Kelly RH, Hales RE. A review of bipolar disorder in adults. Psychiatry. 2006 Sep.

Goldberg JF, Harrow M, eds. Bipolar Disorders: Clinical Course and Outcome. Washington, DC: American Psychiatric Press, 1999.

Goodnick PJ, ed. Mania: Clinical and Research Perspectives. Washington, DC: American Psychiatric Press, 1998.

American Psychiatric Association. Practice guideline for the treatment of patients with bipolar disorder (revision). Am J Psychiatry 2002; 159:1-50.

Judd LL, Akiskal HS, Schettler PJ, Endicott J, Maser J, Solomon DA, Leon AC, Rice JA, Keller MB. The long-term natural history of the weekly symptomatic status of bipolar I disorder.Archives of general psychiatry. 2002 Jun 1; 59(6):530-7. https://doi.org/10.1001/archpsyc.59.6.530

Bauer MS, Simon GE, Ludman E, Unützer J. 'Bipolarity' in bipolar disorder: distribution of manic and depressive symptoms in a treated population. The British Journal of Psychiatry. 2005Jul; 187(1):87-8. https://doi.org/10.1192/bjp.187.1.87

Rihmer Z, Kiss K. Bipolar disorders and suicidal behaviour. Bipolar Disorders. 2002 Sep; 4:21-5. https://doi.org/10.1034/j.1399-5618.4.s1.3.x

Morriss R, Yang M, Chopra A, Bentall R, Paykel E, Scott J. Differential effects of depression and mania symptoms on social adjustment: prospective study in bipolar disorder. Bipolar disorders. 2013 Feb; 15(1):80-91. https://doi.org/10.1111/bdi.12036

Shah N, Grover S, Rao GP. Clinical practice guidelines for management of bipolar disorder. Indian Journal of Psychiatry. 2017 Jan; 59(Suppl 1):S51. https://doi.org/10.4103/0019-5545.196974

Psycho social treatment ref-(Swartz HA, Swanson J. Psychotherapy for bipolar disorder in adults: a review of the evidence. Focus. 2014 Jul; 12(3):251-66. https://doi.org/10.1176/appi.focus.12.3.251

Weiss A, Hussain S, Ng B, Sarma S, Tiller J, Waite S, Loo C. Royal Australian and New Zealand College of Psychiatrists professional practice guidelines for the administration of electroconvulsive therapy. Australian & New Zealand Journal of Psychiatry. 2019 Jul; 53(7):609-23. https://doi.org/10.1177/0004867419839139

Levine J, Chengappa KR, Brar JS, Gershon S, Yablonsky E, Stapf D, Kupfer DJ. Psychotropic drug prescription patterns among patients with bipolar I disorder. Bipolar Disorders. 2000 Jun; 2(2):120-30. https://doi.org/10.1034/j.1399-5618.2000.020205.x

Vega P, Barbeito S, De Azúa SR, Martínez-Cengotitabengoa M, González-Ortega I, Saenz M, González-Pinto A. Bipolar disorder differences between genders: special considerations for women. Women's Health. 2011 Nov; 7(6):663-76. https://doi.org/10.2217/WHE.11.71

Benazzi F. Bipolar II disorder family history using the family history screen: findings and clinical implications. Comprehensive psychiatry. 2004 Mar 1; 45(2): 77-82. https://doi.org/10.1016/j.comppsych.2003.12.003

Dome P, Rihmer Z, Gonda X. Suicide risk in bipolar disorder: a brief review. Medicina. 2019 Aug; 55(8):403. https://doi.org/10.3390/medicina55080403

Johnson SL. Life events in bipolar disorder: towards more specific models. Clinical psychology review. 2005 Dec 1; 25(8):1008-27. https://doi.org/10.1016/j.cpr.2005.06.004

Lin D, Mok H, Yatham LN. Polytherapy in bipolar disorder. CNS drugs. 2006 Jan; 20(1):29- 42. https://doi.org/10.2165/00023210-200620010-00003

Trivedi JK, Sareen H, Yadav VS, Rai SB. Prescription pattern of mood stabilizers for bipolar disorder at a tertiary health care centre in north India. Indian journal of psychiatry. 2013 1Apr; 55(2):131. https://doi.org/10.4103/0019-5545.111449

Walpoth-Niederwanger M, Kemmler G, Grunze H, Weiss U, Hörtnagl C, Strauss R, Blasko I, Hausmann A. Treatment patterns in inpatients with bipolar disorder at a psychiatric university hospital over a 9-year period: focus on mood stabilizers. International clinical psychopharmacology. 2012 Sep 1; 27(5):256-66. https://doi.org/10.1097/YIC.0b013e328356ac92

Lim PZ, Tunis SL, Edell WS, Jensik SE, Tohen M. Medication prescribing patterns for patients with bipolar I disorder in hospital settings: adherence to published practice guidelines. Bipolar Disorders. 2001 Aug; 3(4):165-73. https://doi.org/10.1034/j.1399-5618.2001.30401.x

Hayes J, Prah P, Nazareth I, King M, Walters K, Petersen I, Osborn D. Prescribing trends in bipolar disorder: cohort study in the United Kingdom THIN primary care database 1995-2009. PloS one. 2011 Dec 7; 6(12):e28725. https://doi.org/10.1371/journal.pone.0028725

Published

2022-10-15
Statistics
Abstract Display: 613
PDF Downloads: 527
PDF Downloads: 29

How to Cite

1.
SHAJAHAN A, K R AP, M S M, Safwan M, M A FJ. Comparison and Assessment of Prescribing Pattern of Psychotropic Agents in Bipolar Affective Disorder with Mania and Depression. J. Drug Delivery Ther. [Internet]. 2022 Oct. 15 [cited 2026 Jan. 21];12(5-S):90-9. Available from: https://jddtonline.info/index.php/jddt/article/view/5702

How to Cite

1.
SHAJAHAN A, K R AP, M S M, Safwan M, M A FJ. Comparison and Assessment of Prescribing Pattern of Psychotropic Agents in Bipolar Affective Disorder with Mania and Depression. J. Drug Delivery Ther. [Internet]. 2022 Oct. 15 [cited 2026 Jan. 21];12(5-S):90-9. Available from: https://jddtonline.info/index.php/jddt/article/view/5702