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Søren Østergaard - One of the best experts on this subject based on the ideXlab platform.
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Incident Psychopharmacological Treatment and psychiatric hospital contact in individuals with newly developed type 2 diabetes - a register-based cohort study.
Acta neuropsychiatrica, 2020Co-Authors: Christopher Rohde, Norbert Schmitz, Reimar Werner Thomsen, Søren ØstergaardAbstract:To investigate the association between newly developed type 2 diabetes (T2D) and incident Psychopharmacological Treatment and psychiatric hospital contact. Via Danish registers, we identified all 56 640 individuals from the Central and Northern Denmark Regions with newly developed T2D (defined by the first HbA1c measurement ≥6.5%) in 2000-2016 as well as 315 694 age- and sex-matched controls (without T2D). Those having received Psychopharmacological Treatment or having had a psychiatric hospital contact in the 5 years prior to the onset of T2D were not included. For this cohort, we first assessed the 2-year incidence of Psychopharmacological Treatment and psychiatric hospital contact. Secondly, via Cox regression, we compared the incidence of Psychopharmacological Treatment/psychiatric hospital contact among individuals with T2D to propensity score-matched controls - taking a wide range of potential confounders into account. Finally, via Cox proportional hazards regression, we assessed which baseline (T2D onset) characteristics were associated with subsequent Psychopharmacological Treatment and psychiatric hospital contact. A total of 8.3% of the individuals with T2D initiated Psychopharmacological Treatment compared to 4.6% of the age- and sex-matched controls. Individuals with T2D were at increased risk of initiating Psychopharmacological Treatment compared to the propensity score-matched controls (HR = 1.51, 95% CI = 1.43-1.59), whereas their risk of psychiatric hospital contact was not increased to the same extent (HR = 1.14, 95% CI = 0.98-1.32). Older age, somatic comorbidity, and being divorced/widowed were associated with both Psychopharmacological Treatment and psychiatric hospital contact following T2D. Individuals with T2D are at elevated risk of requiring Psychopharmacological Treatment.
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Incident Psychopharmacological Treatment and psychiatric hospital contact in individuals with newly developed type 2 diabetes
2020Co-Authors: Christopher Rohde, Norbert Schmitz, Reimar Werner Thomsen, Søren ØstergaardAbstract:Objective: To investigate the association between newly developed type 2 diabetes (T2D) and incident Psychopharmacological Treatment and psychiatric hospital contact. Methods: We identified all individuals from the Central- and Northern Denmark Regions with newly developed T2D (defined by the first HbA1c measurement >6.5%) from 2000-2016 and up to five age and sex matched individuals without T2D (controls). Those having received Psychopharmacological Treatment or having had a psychiatric hospital contact in the five years prior to the onset of T2D were excluded. For this cohort, we first assessed the incidence of Psychopharmacological Treatment and psychiatric hospital contact among individuals with T2D and controls, respectively. Secondly, we compared the incidence of Psychopharmacological/psychiatric hospital contact among individuals with T2D to propensity score matched controls. Finally, we assessed which baseline (T2D onset) characteristics that were associated with subsequent Psychopharmacological Treatment and psychiatric hospital contact. Results: We identified 56,640 individuals with newly developed T2D and 315,694 controls. A total of 8.3% of the individuals with T2D initiated Psychopharmacological Treatment within the 2 years following onset compared to 4.6% among the age and sex matched controls. Individuals with T2D were at increased risk of initiating Psychopharmacological Treatment compared to the propensity score matched controls (HR=1.51, 95% CI=1.43-1.59), whereas their risk of psychiatric hospital contact was not increased to the same extent (HR=1.14, 95% CI=0.98-1.32). Older age, somatic comorbidity, and being divorced/widowed was associated with both Psychopharmacological Treatment and psychiatric hospital contact following T2D. Conclusion: Individuals with T2D are at elevated risk of requiring Psychopharmacological Treatment.
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Pre-diagnostic and post-diagnostic Psychopharmacological Treatment of 16 288 patients with bipolar disorder.
Bipolar disorders, 2020Co-Authors: Ole Köhler-forsberg, Christiane Gasse, Fredrik Hieronymus, Liselotte Petersen, Rune H.b. Christensen, Andrew A. Nierenberg, Søren ØstergaardAbstract:Objectives The aim was to describe the pre-diagnostic and post-diagnostic Psychopharmacological Treatment of bipolar disorder over the past two decades. Methods We identified all 16 288 individuals aged ≥ 18 years, who received their first diagnosis of bipolar disorder at a psychiatric hospital in Denmark between 1997 and 2014. For each calendar year, we calculated the proportion of patients (with index date in the respective calendar years) who were prescribed Psychopharmacological Treatment in the 2 years preceding and the 2 years following the date of the first diagnosis of bipolar disorder. For patients diagnosed with bipolar disorder from 2007 to 2010 (n = 3949), we described the Psychopharmacological Treatment from 1995 to 2016, that is, from up to 16 years prior to and up to 10 years after the diagnosis. Results Concomitant use of ≥ 2 antidepressants in the 2 years preceding the bipolar disorder diagnosis increased over the study period. In the 2 years following the diagnosis, the use of lithium decreased, while use of atypical antipsychotics (particularly quetiapine), valproate, and lamotrigine increased over the study period. During the 10 years following the diagnosis, 53%-90% of the patients received any psychotropic drug while 12%-26% received Treatment with an antidepressant without overlapping Treatment with a mood-stabilizing drug. Conclusion The increased use of two or more antidepressants suggests more focus on bipolar disorder as a differential diagnosis to Treatment-resistant unipolar depression. The decreased use of lithium (consistent with international trends) and the prevalent use of antidepressants without overlapping Treatment with a drug with mood-stabilizing properties are concerning.
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Psychopharmacological Treatment of psychotic mania and psychotic bipolar depression compared to non‐psychotic mania and non‐psychotic bipolar depression
Bipolar disorders, 2017Co-Authors: Louise B. Bjørklund, Henriette Thisted Horsdal, Ole Mors, Christiane Gasse, Søren ØstergaardAbstract:Objectives An evidence base for the Treatment of mania and bipolar depression with psychotic symptoms is lacking. Nevertheless, clinicians may have a preference for treating episodes of bipolar disorder with or without psychotic symptoms in different ways, which is likely to reflect notions of differential efficacy of Treatments between these subtypes. This study aimed to investigate whether the Psychopharmacological Treatment of psychotic and non-psychotic episodes of mania and bipolar depression, respectively, differs in clinical practice. Methods We conducted a register-based study assessing the Psychopharmacological Treatment of all individuals receiving their first diagnosis of mania or bipolar depression between 2010 and 2012. The Psychopharmacological Treatment within 3 months following the time of diagnosis was considered. Potential differences in Psychopharmacological Treatment between the psychotic and non-psychotic subtypes of mania and bipolar depression, respectively, were investigated by means of Pearson's χ2 test and logistic regression adjusted for sex and age at diagnosis of bipolar disorder. Results A total of 827 patients were included in the analyses. The adjusted odds ratio (aOR) for Treatment with an antipsychotic was 1.71 (95% confidence interval [CI]: 1.18-2.48, P
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Trends in the Psychopharmacological Treatment of bipolar disorder: a nationwide register-based study.
Acta neuropsychiatrica, 2015Co-Authors: Louise B. Bjørklund, Søren Østergaard, Henriette Thisted Horsdal, Ole Mors, Christiane GasseAbstract:Objective In bipolar disorder, Treatment with antidepressants without concomitant use of mood stabilisers (antidepressant monotherapy) is associated with development of mania and rapid cycling and is therefore not recommended. The present study aimed to investigate the Psychopharmacological Treatment patterns in bipolar disorder over time, with a focus on antidepressant monotherapy. Methods Cohort study with annual cross-sectional assessment of the use of psychotropic medications between 1995 and 2012 for all Danish residents aged 10 years or older with a diagnosis of bipolar disorder registered in the Danish Psychiatric Central Research Register. Users of a given psychotropic medication were defined as individuals having filled at least one prescription for that particular medication in the year of interest. Results We identified 20 618 individuals with bipolar disorder. The proportion of patients with bipolar disorder using antidepressants, atypical antipsychotics and anticonvulsants increased over the study period, while the proportion of patients using lithium, typical antipsychotics and benzodiazepines/sedatives decreased. The proportion of patients treated with antidepressant monotherapy decreased from 20.5% in 1997 to 12.1% in 2012, and among antidepressant users, the proportion in monotherapy decreased from 47.7% to 23.9%, primarily driven by a decrease in the use of tricyclic antidepressants. Conclusion The results show an increase in the proportion of patients with bipolar disorder being treated with antidepressants in the period from 1997 to 2012. However, in accordance with international Treatment guidelines, the extent of antidepressant monotherapy decreased during the same period.
Christiane Gasse - One of the best experts on this subject based on the ideXlab platform.
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Pre-diagnostic and post-diagnostic Psychopharmacological Treatment of 16 288 patients with bipolar disorder.
Bipolar disorders, 2020Co-Authors: Ole Köhler-forsberg, Christiane Gasse, Fredrik Hieronymus, Liselotte Petersen, Rune H.b. Christensen, Andrew A. Nierenberg, Søren ØstergaardAbstract:Objectives The aim was to describe the pre-diagnostic and post-diagnostic Psychopharmacological Treatment of bipolar disorder over the past two decades. Methods We identified all 16 288 individuals aged ≥ 18 years, who received their first diagnosis of bipolar disorder at a psychiatric hospital in Denmark between 1997 and 2014. For each calendar year, we calculated the proportion of patients (with index date in the respective calendar years) who were prescribed Psychopharmacological Treatment in the 2 years preceding and the 2 years following the date of the first diagnosis of bipolar disorder. For patients diagnosed with bipolar disorder from 2007 to 2010 (n = 3949), we described the Psychopharmacological Treatment from 1995 to 2016, that is, from up to 16 years prior to and up to 10 years after the diagnosis. Results Concomitant use of ≥ 2 antidepressants in the 2 years preceding the bipolar disorder diagnosis increased over the study period. In the 2 years following the diagnosis, the use of lithium decreased, while use of atypical antipsychotics (particularly quetiapine), valproate, and lamotrigine increased over the study period. During the 10 years following the diagnosis, 53%-90% of the patients received any psychotropic drug while 12%-26% received Treatment with an antidepressant without overlapping Treatment with a mood-stabilizing drug. Conclusion The increased use of two or more antidepressants suggests more focus on bipolar disorder as a differential diagnosis to Treatment-resistant unipolar depression. The decreased use of lithium (consistent with international trends) and the prevalent use of antidepressants without overlapping Treatment with a drug with mood-stabilizing properties are concerning.
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Psychopharmacological Treatment of psychotic mania and psychotic bipolar depression compared to non‐psychotic mania and non‐psychotic bipolar depression
Bipolar disorders, 2017Co-Authors: Louise B. Bjørklund, Henriette Thisted Horsdal, Ole Mors, Christiane Gasse, Søren ØstergaardAbstract:Objectives An evidence base for the Treatment of mania and bipolar depression with psychotic symptoms is lacking. Nevertheless, clinicians may have a preference for treating episodes of bipolar disorder with or without psychotic symptoms in different ways, which is likely to reflect notions of differential efficacy of Treatments between these subtypes. This study aimed to investigate whether the Psychopharmacological Treatment of psychotic and non-psychotic episodes of mania and bipolar depression, respectively, differs in clinical practice. Methods We conducted a register-based study assessing the Psychopharmacological Treatment of all individuals receiving their first diagnosis of mania or bipolar depression between 2010 and 2012. The Psychopharmacological Treatment within 3 months following the time of diagnosis was considered. Potential differences in Psychopharmacological Treatment between the psychotic and non-psychotic subtypes of mania and bipolar depression, respectively, were investigated by means of Pearson's χ2 test and logistic regression adjusted for sex and age at diagnosis of bipolar disorder. Results A total of 827 patients were included in the analyses. The adjusted odds ratio (aOR) for Treatment with an antipsychotic was 1.71 (95% confidence interval [CI]: 1.18-2.48, P
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Psychopharmacological Treatment of psychotic mania and psychotic bipolar depression compared to non psychotic mania and non psychotic bipolar depression
Bipolar Disorders, 2017Co-Authors: Louise Bjorklund, Henriette Thisted Horsdal, Ole Mors, Christiane Gasse, Soren Dinesen OstergaardAbstract:Objectives An evidence base for the Treatment of mania and bipolar depression with psychotic symptoms is lacking. Nevertheless, clinicians may have a preference for treating episodes of bipolar disorder with or without psychotic symptoms in different ways, which is likely to reflect notions of differential efficacy of Treatments between these subtypes. This study aimed to investigate whether the Psychopharmacological Treatment of psychotic and non-psychotic episodes of mania and bipolar depression, respectively, differs in clinical practice. Methods We conducted a register-based study assessing the Psychopharmacological Treatment of all individuals receiving their first diagnosis of mania or bipolar depression between 2010 and 2012. The Psychopharmacological Treatment within 3 months following the time of diagnosis was considered. Potential differences in Psychopharmacological Treatment between the psychotic and non-psychotic subtypes of mania and bipolar depression, respectively, were investigated by means of Pearson's χ2 test and logistic regression adjusted for sex and age at diagnosis of bipolar disorder. Results A total of 827 patients were included in the analyses. The adjusted odds ratio (aOR) for Treatment with an antipsychotic was 1.71 (95% confidence interval [CI]: 1.18-2.48, P<.01) for psychotic mania and 3.89 (95% CI: 1.95-7.76, P<.001) for psychotic bipolar depression. The aOR for Treatment with the combination of an antipsychotic and an anticonvulsant was 1.60 (95% CI: 1.06-2.43, P<.05) for psychotic mania. The aOR for Treatment with the combination of an antipsychotic and an antidepressant was 2.50 (95% CI: 1.43-4.37, P<.01) for bipolar psychotic depression. Conclusions It would be of interest to conduct studies evaluating whether antipsychotics represent the superior pharmacological Treatment for psychotic mania and psychotic bipolar depression.
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Trends in the Psychopharmacological Treatment of bipolar disorder: a nationwide register-based study.
Acta neuropsychiatrica, 2015Co-Authors: Louise B. Bjørklund, Søren Østergaard, Henriette Thisted Horsdal, Ole Mors, Christiane GasseAbstract:Objective In bipolar disorder, Treatment with antidepressants without concomitant use of mood stabilisers (antidepressant monotherapy) is associated with development of mania and rapid cycling and is therefore not recommended. The present study aimed to investigate the Psychopharmacological Treatment patterns in bipolar disorder over time, with a focus on antidepressant monotherapy. Methods Cohort study with annual cross-sectional assessment of the use of psychotropic medications between 1995 and 2012 for all Danish residents aged 10 years or older with a diagnosis of bipolar disorder registered in the Danish Psychiatric Central Research Register. Users of a given psychotropic medication were defined as individuals having filled at least one prescription for that particular medication in the year of interest. Results We identified 20 618 individuals with bipolar disorder. The proportion of patients with bipolar disorder using antidepressants, atypical antipsychotics and anticonvulsants increased over the study period, while the proportion of patients using lithium, typical antipsychotics and benzodiazepines/sedatives decreased. The proportion of patients treated with antidepressant monotherapy decreased from 20.5% in 1997 to 12.1% in 2012, and among antidepressant users, the proportion in monotherapy decreased from 47.7% to 23.9%, primarily driven by a decrease in the use of tricyclic antidepressants. Conclusion The results show an increase in the proportion of patients with bipolar disorder being treated with antidepressants in the period from 1997 to 2012. However, in accordance with international Treatment guidelines, the extent of antidepressant monotherapy decreased during the same period.
Ole Mors - One of the best experts on this subject based on the ideXlab platform.
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Psychopharmacological Treatment of psychotic mania and psychotic bipolar depression compared to non‐psychotic mania and non‐psychotic bipolar depression
Bipolar disorders, 2017Co-Authors: Louise B. Bjørklund, Henriette Thisted Horsdal, Ole Mors, Christiane Gasse, Søren ØstergaardAbstract:Objectives An evidence base for the Treatment of mania and bipolar depression with psychotic symptoms is lacking. Nevertheless, clinicians may have a preference for treating episodes of bipolar disorder with or without psychotic symptoms in different ways, which is likely to reflect notions of differential efficacy of Treatments between these subtypes. This study aimed to investigate whether the Psychopharmacological Treatment of psychotic and non-psychotic episodes of mania and bipolar depression, respectively, differs in clinical practice. Methods We conducted a register-based study assessing the Psychopharmacological Treatment of all individuals receiving their first diagnosis of mania or bipolar depression between 2010 and 2012. The Psychopharmacological Treatment within 3 months following the time of diagnosis was considered. Potential differences in Psychopharmacological Treatment between the psychotic and non-psychotic subtypes of mania and bipolar depression, respectively, were investigated by means of Pearson's χ2 test and logistic regression adjusted for sex and age at diagnosis of bipolar disorder. Results A total of 827 patients were included in the analyses. The adjusted odds ratio (aOR) for Treatment with an antipsychotic was 1.71 (95% confidence interval [CI]: 1.18-2.48, P
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Psychopharmacological Treatment of psychotic mania and psychotic bipolar depression compared to non psychotic mania and non psychotic bipolar depression
Bipolar Disorders, 2017Co-Authors: Louise Bjorklund, Henriette Thisted Horsdal, Ole Mors, Christiane Gasse, Soren Dinesen OstergaardAbstract:Objectives An evidence base for the Treatment of mania and bipolar depression with psychotic symptoms is lacking. Nevertheless, clinicians may have a preference for treating episodes of bipolar disorder with or without psychotic symptoms in different ways, which is likely to reflect notions of differential efficacy of Treatments between these subtypes. This study aimed to investigate whether the Psychopharmacological Treatment of psychotic and non-psychotic episodes of mania and bipolar depression, respectively, differs in clinical practice. Methods We conducted a register-based study assessing the Psychopharmacological Treatment of all individuals receiving their first diagnosis of mania or bipolar depression between 2010 and 2012. The Psychopharmacological Treatment within 3 months following the time of diagnosis was considered. Potential differences in Psychopharmacological Treatment between the psychotic and non-psychotic subtypes of mania and bipolar depression, respectively, were investigated by means of Pearson's χ2 test and logistic regression adjusted for sex and age at diagnosis of bipolar disorder. Results A total of 827 patients were included in the analyses. The adjusted odds ratio (aOR) for Treatment with an antipsychotic was 1.71 (95% confidence interval [CI]: 1.18-2.48, P<.01) for psychotic mania and 3.89 (95% CI: 1.95-7.76, P<.001) for psychotic bipolar depression. The aOR for Treatment with the combination of an antipsychotic and an anticonvulsant was 1.60 (95% CI: 1.06-2.43, P<.05) for psychotic mania. The aOR for Treatment with the combination of an antipsychotic and an antidepressant was 2.50 (95% CI: 1.43-4.37, P<.01) for bipolar psychotic depression. Conclusions It would be of interest to conduct studies evaluating whether antipsychotics represent the superior pharmacological Treatment for psychotic mania and psychotic bipolar depression.
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Trends in the Psychopharmacological Treatment of bipolar disorder: a nationwide register-based study.
Acta neuropsychiatrica, 2015Co-Authors: Louise B. Bjørklund, Søren Østergaard, Henriette Thisted Horsdal, Ole Mors, Christiane GasseAbstract:Objective In bipolar disorder, Treatment with antidepressants without concomitant use of mood stabilisers (antidepressant monotherapy) is associated with development of mania and rapid cycling and is therefore not recommended. The present study aimed to investigate the Psychopharmacological Treatment patterns in bipolar disorder over time, with a focus on antidepressant monotherapy. Methods Cohort study with annual cross-sectional assessment of the use of psychotropic medications between 1995 and 2012 for all Danish residents aged 10 years or older with a diagnosis of bipolar disorder registered in the Danish Psychiatric Central Research Register. Users of a given psychotropic medication were defined as individuals having filled at least one prescription for that particular medication in the year of interest. Results We identified 20 618 individuals with bipolar disorder. The proportion of patients with bipolar disorder using antidepressants, atypical antipsychotics and anticonvulsants increased over the study period, while the proportion of patients using lithium, typical antipsychotics and benzodiazepines/sedatives decreased. The proportion of patients treated with antidepressant monotherapy decreased from 20.5% in 1997 to 12.1% in 2012, and among antidepressant users, the proportion in monotherapy decreased from 47.7% to 23.9%, primarily driven by a decrease in the use of tricyclic antidepressants. Conclusion The results show an increase in the proportion of patients with bipolar disorder being treated with antidepressants in the period from 1997 to 2012. However, in accordance with international Treatment guidelines, the extent of antidepressant monotherapy decreased during the same period.
Henriette Thisted Horsdal - One of the best experts on this subject based on the ideXlab platform.
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Psychopharmacological Treatment of psychotic mania and psychotic bipolar depression compared to non‐psychotic mania and non‐psychotic bipolar depression
Bipolar disorders, 2017Co-Authors: Louise B. Bjørklund, Henriette Thisted Horsdal, Ole Mors, Christiane Gasse, Søren ØstergaardAbstract:Objectives An evidence base for the Treatment of mania and bipolar depression with psychotic symptoms is lacking. Nevertheless, clinicians may have a preference for treating episodes of bipolar disorder with or without psychotic symptoms in different ways, which is likely to reflect notions of differential efficacy of Treatments between these subtypes. This study aimed to investigate whether the Psychopharmacological Treatment of psychotic and non-psychotic episodes of mania and bipolar depression, respectively, differs in clinical practice. Methods We conducted a register-based study assessing the Psychopharmacological Treatment of all individuals receiving their first diagnosis of mania or bipolar depression between 2010 and 2012. The Psychopharmacological Treatment within 3 months following the time of diagnosis was considered. Potential differences in Psychopharmacological Treatment between the psychotic and non-psychotic subtypes of mania and bipolar depression, respectively, were investigated by means of Pearson's χ2 test and logistic regression adjusted for sex and age at diagnosis of bipolar disorder. Results A total of 827 patients were included in the analyses. The adjusted odds ratio (aOR) for Treatment with an antipsychotic was 1.71 (95% confidence interval [CI]: 1.18-2.48, P
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Psychopharmacological Treatment of psychotic mania and psychotic bipolar depression compared to non psychotic mania and non psychotic bipolar depression
Bipolar Disorders, 2017Co-Authors: Louise Bjorklund, Henriette Thisted Horsdal, Ole Mors, Christiane Gasse, Soren Dinesen OstergaardAbstract:Objectives An evidence base for the Treatment of mania and bipolar depression with psychotic symptoms is lacking. Nevertheless, clinicians may have a preference for treating episodes of bipolar disorder with or without psychotic symptoms in different ways, which is likely to reflect notions of differential efficacy of Treatments between these subtypes. This study aimed to investigate whether the Psychopharmacological Treatment of psychotic and non-psychotic episodes of mania and bipolar depression, respectively, differs in clinical practice. Methods We conducted a register-based study assessing the Psychopharmacological Treatment of all individuals receiving their first diagnosis of mania or bipolar depression between 2010 and 2012. The Psychopharmacological Treatment within 3 months following the time of diagnosis was considered. Potential differences in Psychopharmacological Treatment between the psychotic and non-psychotic subtypes of mania and bipolar depression, respectively, were investigated by means of Pearson's χ2 test and logistic regression adjusted for sex and age at diagnosis of bipolar disorder. Results A total of 827 patients were included in the analyses. The adjusted odds ratio (aOR) for Treatment with an antipsychotic was 1.71 (95% confidence interval [CI]: 1.18-2.48, P<.01) for psychotic mania and 3.89 (95% CI: 1.95-7.76, P<.001) for psychotic bipolar depression. The aOR for Treatment with the combination of an antipsychotic and an anticonvulsant was 1.60 (95% CI: 1.06-2.43, P<.05) for psychotic mania. The aOR for Treatment with the combination of an antipsychotic and an antidepressant was 2.50 (95% CI: 1.43-4.37, P<.01) for bipolar psychotic depression. Conclusions It would be of interest to conduct studies evaluating whether antipsychotics represent the superior pharmacological Treatment for psychotic mania and psychotic bipolar depression.
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Trends in the Psychopharmacological Treatment of bipolar disorder: a nationwide register-based study.
Acta neuropsychiatrica, 2015Co-Authors: Louise B. Bjørklund, Søren Østergaard, Henriette Thisted Horsdal, Ole Mors, Christiane GasseAbstract:Objective In bipolar disorder, Treatment with antidepressants without concomitant use of mood stabilisers (antidepressant monotherapy) is associated with development of mania and rapid cycling and is therefore not recommended. The present study aimed to investigate the Psychopharmacological Treatment patterns in bipolar disorder over time, with a focus on antidepressant monotherapy. Methods Cohort study with annual cross-sectional assessment of the use of psychotropic medications between 1995 and 2012 for all Danish residents aged 10 years or older with a diagnosis of bipolar disorder registered in the Danish Psychiatric Central Research Register. Users of a given psychotropic medication were defined as individuals having filled at least one prescription for that particular medication in the year of interest. Results We identified 20 618 individuals with bipolar disorder. The proportion of patients with bipolar disorder using antidepressants, atypical antipsychotics and anticonvulsants increased over the study period, while the proportion of patients using lithium, typical antipsychotics and benzodiazepines/sedatives decreased. The proportion of patients treated with antidepressant monotherapy decreased from 20.5% in 1997 to 12.1% in 2012, and among antidepressant users, the proportion in monotherapy decreased from 47.7% to 23.9%, primarily driven by a decrease in the use of tricyclic antidepressants. Conclusion The results show an increase in the proportion of patients with bipolar disorder being treated with antidepressants in the period from 1997 to 2012. However, in accordance with international Treatment guidelines, the extent of antidepressant monotherapy decreased during the same period.
Soren Dinesen Ostergaard - One of the best experts on this subject based on the ideXlab platform.
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Psychopharmacological Treatment of psychotic mania and psychotic bipolar depression compared to non psychotic mania and non psychotic bipolar depression
Bipolar Disorders, 2017Co-Authors: Louise Bjorklund, Henriette Thisted Horsdal, Ole Mors, Christiane Gasse, Soren Dinesen OstergaardAbstract:Objectives An evidence base for the Treatment of mania and bipolar depression with psychotic symptoms is lacking. Nevertheless, clinicians may have a preference for treating episodes of bipolar disorder with or without psychotic symptoms in different ways, which is likely to reflect notions of differential efficacy of Treatments between these subtypes. This study aimed to investigate whether the Psychopharmacological Treatment of psychotic and non-psychotic episodes of mania and bipolar depression, respectively, differs in clinical practice. Methods We conducted a register-based study assessing the Psychopharmacological Treatment of all individuals receiving their first diagnosis of mania or bipolar depression between 2010 and 2012. The Psychopharmacological Treatment within 3 months following the time of diagnosis was considered. Potential differences in Psychopharmacological Treatment between the psychotic and non-psychotic subtypes of mania and bipolar depression, respectively, were investigated by means of Pearson's χ2 test and logistic regression adjusted for sex and age at diagnosis of bipolar disorder. Results A total of 827 patients were included in the analyses. The adjusted odds ratio (aOR) for Treatment with an antipsychotic was 1.71 (95% confidence interval [CI]: 1.18-2.48, P<.01) for psychotic mania and 3.89 (95% CI: 1.95-7.76, P<.001) for psychotic bipolar depression. The aOR for Treatment with the combination of an antipsychotic and an anticonvulsant was 1.60 (95% CI: 1.06-2.43, P<.05) for psychotic mania. The aOR for Treatment with the combination of an antipsychotic and an antidepressant was 2.50 (95% CI: 1.43-4.37, P<.01) for bipolar psychotic depression. Conclusions It would be of interest to conduct studies evaluating whether antipsychotics represent the superior pharmacological Treatment for psychotic mania and psychotic bipolar depression.