Psychotropic Drug Polypharmacy in Bipolar Disorder

The psychotropic drugs mentioned in this study were mood stabilizers (MSs), antipsychotics (APs), antidepressants (ADs), and benzodiazepines (BZDs). Mood stabilizers were defined as valproate, lithium, lamotrigine, oxcarbazepine, or topiramate. Second-generation antipsychotics are also effective mood stabilizers, but they were classified separately in order to better classify the drugs taken and compare them with previous studies. Trazodone and mirtazapine were considered antidepressants, although they were often used to improve sleep. These included benzodiazepines, because they are commonly used in patients with BD. For each patient, the prescribed daily dose (PDD) was defined as the daily dose. The type of medication taken was defined as the daily use of any medication within the type of medication.
Polypharmacy was defined as the use of two or more psychotropic drugs. Polypharmacy might involve the same class of drugs, such as two antidepressants, or different classes of drugs, such as mood stabilizers and antipsychotics. Fifteen types of medication classes were analyzed, including four types of monotherapies, six types with two different classes of drug co-treatments, four types with three different classes of drug co-treatments, and one type with four different classes of drug co-treatment. For all patients, the numbers of drugs used were collected at baseline and at each follow-up assessment. The changes in the drug numbers were observed from the collection of these data.