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Prescription Patterns for Bipolar Disorder in Asian Countries: Findings from Research on Asian Prescription Pattern-Bipolar Disorder
Lin, Shih Ku1,2; Yang, Shu Yu3; Park, Seon Cheol4; Jang, Ok Jin5; Zhu, Xiaomin6; Xiang, Yu Tao7,8; Ouyang, Wen Chen9,10,11; Javed, Afzal12; Khan, M. Nasar Sayeed13; Grover, Sandeep14; Avasthi, Ajit14; Kallivayalil, Roy Abraham15; Chee, Kok Yoon16; Chemi, Norliza17; Kato, Takahiro A.18; Hayakawa, Kohei18; Pariwatcharakul, Pornjira19; Maramis, Margarita20; Seneviratne, Lakmi21; Kang, Sim22; Tang, Wai Kwong23; Oo, Tin24; Sartorius, Norman25; Tan, Chay Hoon26; Chong, Mian Yoon27; Park, Yong Chon4; Shinfuku, Naotaka28
Source PublicationClinical Psychopharmacology and Neuroscience

Objective: Pharmacotherapy including mood stabilizers and antipsychotics are frequently used in bipolar disorder (BD); however, the lack of consensus regarding the definition of polypharmacy hinders conducting comparative studies across different settings and countries. Research on Asian Prescription Pattern (REAP) is the largest and the longest lasting international collaborative research in psychiatry in Asia. The objective of REAP BD was to investigate the prescription patterns of psychotropic medications across Asian countries. The rates of polypharmacy and psychotropic drug load were also analyzed. Methods: The data collection was web-based. Prescription patterns were categorized as (1) mood stabilizer monotherapy: one mood stabilizer; (2) antipsychotic monotherapy: one antipsychotic; (3) simple polypharmacy: one mood stabilizer and one antipsychotic; and (4) complex polypharmacy: ≥ 2 mood stabilizers or/and antipsychotics. The psychotropic drug load in each patient was calculated using the defined daily dose method. Results: Among 2003 patients with BD (52.1% female, 42.4 years) from 12 countries, 1,619 (80.8%) patients received mood stabilizers, 1,644 (82.14%) received antipsychotics, and 424 (21.2%) received antidepressants, with 14.7% mood stabilizer monotherapy, 13.4% antipsychotic monotherapy, 48.9% simple polypharmacy, 20.3% complex polypharmacy, and 2.6% other therapy. The average psychotropic drug load was 2.05 ± 1.40. Results varied widely between countries. Conclusion: Over 70% of psychotropic regimens involved polypharmacy, which accords with the high prevalence of polypharmacy in BD under a permissive criterion (2 or more core psychotropic drugs) worldwide. Notably, ≥ 80% of our sample received antipsychotics, which may indicate an increasing trend in antipsychotic use for BD treatment.

KeywordAntipsychotics Bipolar Disorder Mood Stabilizers Polypharmacy Psychotropic Drug Load
URLView the original
Indexed BySCIE
WOS Research AreaNeurosciences & Neurology ; Pharmacology & Pharmacy
WOS SubjectNeurosciences ; Pharmacology & Pharmacy
WOS IDWOS:000750155400002
Scopus ID2-s2.0-85124493717
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Document TypeJournal article
CollectionFaculty of Health Sciences
Corresponding AuthorLin, Shih Ku
Affiliation1.Department of Psychiatry, Taipei City Hospital and Psychiatric Center, Taipei, Taiwan
2.Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
3.Department of Pharmacy, Taipei City Hospital, Taipei, Taiwan
4.Department of Neuropsychiatry, Hanyang University Guri Hospital, Guri, South Korea
5.Department of Psychiatry, Bugok National Hospital, Changyeong, South Korea
6.Department of Psychiatry, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
7.Department of Psychiatry, Beijing Anding Hospital of Capital Medical University, Beijing, China
8.Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao
9.Department of Geriatric Psychiatry, Jianan Psychiatric Center, Tainan, Taiwan
10.Department of Psychiatry, Kaohsiung Medical University, Kaohsiung, Taiwan
11.Department of Nursing, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan
12.Pakistan Psychiatric Research Centre, Fountain House, Lahore, Pakistan
13.Department of Psychiatry, Services Hospital, Lahore, Pakistan
14.Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
15.Pushpagiri Institute of Medical Sciences, Tiruvalla, India
16.Department of Psychiatry and Mental Health, Tunku Abdul Rahman Institute of Neurosciences, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
17.Department of Psychiatry and Mental Health, Hospital Kajang, Selangor, Malaysia
18.Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
19.Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
20.Department of Psychiatry, Dr. Soetomo Hospital, Faculty of Medicine, Airlangga University, Surabaya, Indonesia
21.Department of Psychiatry, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
22.Institute of Mental Health, Buangkok Green Medical Park, Singapore
23.Department of Psychiatry, Chinese University of Hong Kong, Hong Kong
24.Mental Health Hospital, Yangon University of Medicine, Yangon, Myanmar
25.Association for the Improvement of Mental Health Programs, Geneva, Switzerland
26.Department of Pharmacology, National University of Singapore, Singapore
27.Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Chang Gung University, School of Medicine, Linkou, Taiwan
28.School of Human Sciences, Seinan Gakuin University, Fukuoka, Japan
Recommended Citation
GB/T 7714
Lin, Shih Ku,Yang, Shu Yu,Park, Seon Cheol,et al. Prescription Patterns for Bipolar Disorder in Asian Countries: Findings from Research on Asian Prescription Pattern-Bipolar Disorder[J]. Clinical Psychopharmacology and Neuroscience,2022,20(1):61-69.
APA Lin, Shih Ku.,Yang, Shu Yu.,Park, Seon Cheol.,Jang, Ok Jin.,Zhu, Xiaomin.,Xiang, Yu Tao.,Ouyang, Wen Chen.,Javed, Afzal.,Khan, M. Nasar Sayeed.,Grover, Sandeep.,Avasthi, Ajit.,Kallivayalil, Roy Abraham.,Chee, Kok Yoon.,Chemi, Norliza.,Kato, Takahiro A..,Hayakawa, Kohei.,Pariwatcharakul, Pornjira.,Maramis, Margarita.,Seneviratne, Lakmi.,...&Shinfuku, Naotaka.(2022).Prescription Patterns for Bipolar Disorder in Asian Countries: Findings from Research on Asian Prescription Pattern-Bipolar Disorder.Clinical Psychopharmacology and Neuroscience,20(1),61-69.
MLA Lin, Shih Ku,et al."Prescription Patterns for Bipolar Disorder in Asian Countries: Findings from Research on Asian Prescription Pattern-Bipolar Disorder".Clinical Psychopharmacology and Neuroscience 20.1(2022):61-69.
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