Changing Trends in Treatment of Acute Mania: Experience of a Tertiary Centre Over a Decade

We investigated trends over a decade in the prescription of lithium, antiepileptics, and antipsychotic agents at discharge for patients hospitalised for acute mania. We conducted a retrospective review of medical records for 165 inpatients with acute mania who had been hospitalised in Cerrahpaşa Fac...

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Bibliographic Details
Published in:	Psychiatric quarterly Vol. 87; no. 2; pp. 305 - 313
Main Authors:	Arıkan, Mehmet Kemal, Poyraz, Cana Aksoy, Baş, Alper, Sağlam, N. Gamze Usta, Batun, Gizem Cetiner, Gültekin, Gözde, Poyraz, Burç Çağrı
Format:	Journal Article
Language:	English
Published:	New York Springer US 01-06-2016 Springer Nature B.V
Subjects:	Acute Adolescent Adult Affective disorders Aged Anticonvulsants - therapeutic use Antipsychotic Agents - therapeutic use Antipsychotics Bipolar disorder Bipolar Disorder - drug therapy Bipolar Disorder - therapy Carbamazepine Change agents College professors Drug therapy Drug Therapy, Combination - trends Drug Utilization - trends Electroconvulsive therapy Electroconvulsive Therapy - trends Female Haloperidol Hospitalization Humans Lithium Lithium Compounds - therapeutic use Male Mania Medical records Medicine Medicine & Public Health Middle Aged Olanzapine Original Paper Patients Psychiatry Psychotropic drugs Public Health Quetiapine Retrospective Studies Risperidone Second generation Sociology Valproic acid Young Adult Istanbul Turkey Turkey Pharmacotherapy Bipolar disorder Acute mania ECT
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Summary:	We investigated trends over a decade in the prescription of lithium, antiepileptics, and antipsychotic agents at discharge for patients hospitalised for acute mania. We conducted a retrospective review of medical records for 165 inpatients with acute mania who had been hospitalised in Cerrahpaşa Faculty of Medicine, Department of Psychiatry during 2001–2002 and 2011–2012. Among 165 patients, prescription of olanzapine at discharge increased from 3 to 46 % ( p < 0.001), while prescription of haloperidol decreased from 55 to 21 % ( p < 0.001). Use of other atypical antipsychotics did not change significantly (risperidone decreased from 14 to 11 %, p = 0.5; quetiapine increased from 10 to 16 %, p = 0.2). Use of valproate, carbamazepine, and lithium did not change significantly. Use of electroconvulsive therapy in acute mania decreased by half from 27 to 13 % ( p = 0.02). Typical antipsychotics alone or in combination with antiepileptics were the most common treatment regimen at discharge at 2001–2002; while 10 years later, they had been largely replaced by lithium or antiepileptics combined with second generation antipsychotics. Antipsychotic agents remained to be an important component of acute treatment of mania in our practice.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0033-2720 1573-6709
DOI:	10.1007/s11126-015-9388-9