@article{9fffb0be57ff45609ffd6642bd3883c3,
title = "Patterns of pharmacotherapy for bipolar disorder: A GBC survey",
abstract = "OBJECTIVES: To understand treatment practices for bipolar disorders (BD), this study leveraged the Global Bipolar Cohort collaborative network to investigate pharmacotherapeutic treatment patterns in multiple cohorts of well-characterized individuals with BD in North America, Europe, and Australia.METHODS: Data on pharmacotherapy, demographics, diagnostic subtypes, and comorbidities were provided from each participating cohort. Individual site and regional pooled proportional meta-analyses with generalized linear mixed methods were conducted to identify prescription patterns.RESULTS: This study included 10,351 individuals from North America (n = 3985), Europe (n = 3822), and Australia (n = 2544). Overall, participants were predominantly female (60%) with BD-I (60%; vs. BD-II = 33%). Cross-sectionally, mood-stabilizing anticonvulsants (44%), second-generation antipsychotics (42%), and antidepressants (38%) were the most prescribed medications. Lithium was prescribed in 29% of patients, primarily in the Australian (31%) and European (36%) cohorts. First-generation antipsychotics were prescribed in 24% of the European versus 1% in the North American cohort. Antidepressant prescription rates were higher in BD-II (47%) compared to BD-I (35%). Major limitations were significant differences among cohorts based on inclusion/exclusion criteria, data source, and time/year of enrollment into cohort.CONCLUSIONS: Mood-stabilizing anticonvulsants, second-generation antipsychotics, and antidepressants were the most prescribed medications suggesting prescription patterns that are not necessarily guideline concordant. Significant differences exist in the prescription practices across different geographic regions, especially the underutilization of lithium in the North American cohorts and the higher utilization of first-generation antipsychotics in the European cohorts. There is a need to conduct future longitudinal studies to further explore these differences and their impact on outcomes, and to inform and implement evidence-based guidelines to help improve treatment practices in BD.",
author = "{FACE-BD Collaborators, The Global Bipolar Cohort Collaborative} and Balwinder Singh and Yocum, {Anastasia K} and Rebecca Strawbridge and Burdick, {Katherine E} and Millett, {Caitlin E} and Peters, {Amy T} and Sperry, {Sarah H} and Giovanna Fico and Eduard Vieta and Norma Verdolini and Ophelia Godin and Marion Leboyer and Bruno Etain and Tso, {Ivy F} and Coombes, {Brandon J} and McInnis, {Melvin G} and Nierenberg, {Andrew A} and Young, {Allan H} and Ashton, {Melanie M} and Michael Berk and Williams, {Lana J} and Kamyar Keramatian and Yatham, {Lakshmi N} and Overs, {Bronwyn J} and Fullerton, {Janice M} and Gloria Roberts and Mitchell, {Philip B} and Andreassen, {Ole A} and Andreazza, {Ana C} and Zandi, {Peter P} and Daniel Pham and Biernacka, {Joanna M} and Frye, {Mark A}",
note = "{\textcopyright} 2023 The Authors. Bipolar Disorders published by John Wiley & Sons Ltd. Funding Information: NV has received financial support for CME activities and travel funds from the following entities (unrelated to the present work): Angelini, Janssen‐Cilag, Lundbeck, Otsuka. GF work is supported by a fellowship from “La Caixa Foundation (ID 100010434 fellowship code LCF/BQ/DR21/11880019). RS has received honoraria from Janssen. AHY has undertaken paid lectures and advisory boards for the following companies with drugs used in affective and related disorders: Astrazenaca, Boehringer Ingelheim, Eli Lilly, LivaNova, Lundbeck, Sunovion, Servier, Livanova, Janssen, Allegan, Bionomics, Sumitomo Dainippon Pharma, COMPASS, Sage, Novartis, and Neurocentrx; is Principal Investigator in the Restore‐Life VNS registry study funded by LivaNova; Principal Investigator on ESKETINTRD3004: “An Open‐label, Long‐term, Safety and Efficacy Study of Intranasal Esketamine in Treatment‐resistant Depression”; Principal Investigator on “The Effects of Psilocybin on Cognitive Function in Healthy Participants”; Principal Investigator on “The Safety and Efficacy of Psilocybin in Participants with Treatment‐Resistant Depression (P‐TRD)”; and UK Chief Investigator for Novartis MDD study MIJ821A12201. Funding Information: We acknowledge and thank Ms. Claudia Diaz‐Byrd, MS, the GBC program manager, for her efforts toward the success of this study. We also acknowledge people with BD who participated and research staff at each site. MB is supported by a NHMRC Senior Principal Research Fellowship and Leadership 3 Investigator grant (1156072 and 2017131). The FACE‐BD cohort was supported by the Foundation FondaMental, Institut National de la Sant{\'e} et de la Recherche M{\'e}dicale (INSERM), AP‐HP, and by the Investissements d'Avenir Program managed by the ANR under reference ANR‐11‐IDEX‐0004‐02 and ANR‐10‐COHO‐10‐01. The CRiB study (RS, AHY) funded by the National Institute of Health and Care Research (NIHR) Research for Patient Benefit program (ID PB‐PG‐0614‐34075) and NIHR Maudsley Biomedical Research Centre. MB is supported by a NHMRC Senior Principal Research Fellowship and Leadership 3 Investigator grant (1156072 and 2017131). PBM was supported by a NHMRC Leadership 3 Investigator grant (1177991), Program Grant 1037196, and the Lansdown Foundation.NeuRA investigators (JMF, BJO) thank the Sax Institute for access to The 45 and Up Study data (project 17011), and the supporting partner organizations including Cancer Council NSW, The National Heart Foundation (NSW Division), NSW Ministry of Health, and the Australian Red Cross Blood Service. We acknowledge the Sax Institute's Secure Unified Research Environment (SURE) for the provision of secure data access. We also thank the NSW Ministry of Health, Services Australia, and the Centre for Health Record Linkage (CHeReL) for provision of linked administrative health data. This work was supported by grants from the Commonwealth Government administered through The Mindgardens Neuroscience Network, and the Medical Research Futures Fund—Emerging Priorities and Consumer Driven Research Initiative Pharmacogenomics Grant (MRF1200428)—administered through the Australian National Health and Medical Research Council (NHMRC). We also thank generous supporters of NeuRA, namely Mrs. Betty Lynch OAM (dec), the directors of The Aberdeen Fund, the Janette Mary O'Neil Research Fellowship (JMF) and the McQuiggin family, and the many thousands of people participating in the 45 and Up Study.The BWH cohort collection was funded by a grant from the National Institute of Mental Health (R01MH100125 to KEB). Dr. Lana Williams is supported by a NHMRC Emerging Leader Fellowship (1174060). The Deakin project is supported by a competitive project grant from the National Health and Medical Research Council (NHMRC; ID 1104438). Funding Information: BS has received research grant support from the Mayo Clinic and the NNDC Momentum grant (unrelated to this study). EV has received grants and served as consultant, advisor, or CME speaker for the following entities: AB‐Biotics, AbbVie, Adamed, Angelini, Biogen, Boehringer‐Ingelheim, Celon Pharma, Compass, Dainippon Sumitomo Pharma, Ferrer, Gedeon Richter, GH Research, Glaxo‐Smith Kline, Janssen, Lundbeck, Medincell, Merck, Novartis, Orion Corporation, Organon, Otsuka, Rovi, Sage, Sanofi‐Aventis, Sunovion, Takeda, and Viatris, outside the submitted work. EV's research was supported by CIBER—Consorcio Centro de Investigaci{\'o}n Biom{\'e}dica en Red—(CB07/09/0004), Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation. EV thanks the support of the Spanish Ministry of Science and Innovation (PI18/00805, PI21/00787) integrated into the Plan Nacional de I + D + I and cofinanced by the ISCIII‐Subdirecci{\'o}n General de Evaluaci{\'o}n and the Fondo Europeo de Desarrollo Regional (FEDER), the Instituto de Salud Carlos III, the Secretaria d'Universitats i Recerca del Departament d'Economia i Coneixement (2017 SGR 1365), the CERCA Programme, and the Departament de Salut de la Generalitat de Catalunya for the PERIS grant SLT006/17/00357. Thanks to the support of the European Union Horizon 2020 research and innovation program (EU.3.1.1. Understanding health, well‐being and disease: Grant No 754907 and EU.3.1.3. Treating and managing disease: Grant No 945151). Funding Information: MAF has received research support from Assurex Health, Mayo Foundation, CME/Travel/Honoraria from Carnot Laboratories and American Physician Institute and has Financial Interest/Stock ownership/Royalties in Chymia LLC. The Mayo Clinic Bipolar Biobank was supported by the J. Willard and Alice S. Marriott Foundation. The sponsor did not have a role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication. Funding Information: KK has served on the scientific advisory board of AbbVie, and is supported by the Vancouver Coastal Health Research Institute Investigator Award. Publisher Copyright: {\textcopyright} 2023 The Authors. Bipolar Disorders published by John Wiley & Sons Ltd.",
year = "2023",
month = jul,
day = "18",
doi = "10.1111/bdi.13366",
language = "English",
journal = "Bipolar Disorders",
issn = "1398-5647",
publisher = "Blackwell Munksgaard",
}