Bipolar disorder (BD) affects over 1% of the global population, with varying prevalence rates across different types, including bipolar I, bipolar II, and sub-threshold bipolar disorder. Acute mania, a psychiatric emergency, is marked by elevated mood, impulsivity, and risky behavior, leading to significant functional impairment. Treatment relies on pharmacological therapies, primarily mood stabilizers and antipsychotics, with polypharmacy common in both inpatient and outpatient settings. Treatment decisions depend on efficacy, safety, patient characteristics, and the influence of treatment resistance, psychiatric comorbidities, and patient history.
This 14-year study in Taiwan analyzed medication prescription trends for patients discharged with bipolar mania. It found significant shifts, including increased use of second-generation antipsychotics (SGAs) and valproate, alongside a decline in first-generation antipsychotics (FGAs). Complex polypharmacy also rose, reflecting the challenges of treating bipolar disorder. The study highlights the need for further research into the long-term effects of these prescribing trends, especially regarding medical nonadherence, adverse side effects, and drug interactions. Researchers also underscore the need for tailored approaches to managing acute mania.
Reference: Chiu HP, Shih Y, Lin CH. Fourteen-year trends in prescribing patterns for patients with bipolar mania discharged from a public psychiatric hospital in Taiwan. Medicine (Baltimore). 2024 Mar 1;103(9):e37270. doi: 10.1097/MD.0000000000037270. PMID: 38428897; PMCID: PMC10906621.