Clinical Use of Mood Stabilizers With Antidepressants in Asia: Report From the Research on Asian Psychotropic Prescription Patterns for Antidepressants (REAP-AD) Projects in 2004 and 2013

J Clin Psychopharmacol. 2017 Apr;37(2):255-259. doi: 10.1097/JCP.0000000000000670.

Abstract

Objective: As most reports concerning treatment with combinations of mood stabilizer (MS) with antidepressant (AD) drugs are based in the West, we surveyed characteristics of such cotreatment in 42 sites caring for the mentally ill in 10 Asian countries.

Methods: This cross-sectional, pharmacoepidemiologic study used 2004 and 2013 data from the REAP-AD (Research Study on Asian Psychotropic Prescription Patterns for Antidepressants) to evaluate the rates and doses of MSs given with ADs and associated factors in 4164 psychiatric patients, using standard bivariate methods followed by multivariable logistic regression modeling.

Results: Use of MS + AD increased by 104% (5.5% to 11.2%) between 2004 and 2013 and was much more associated with diagnosis of bipolar disorder than major depression or anxiety disorder, as well as with hospitalization > outpatient care, psychiatric > general-medical programs, and young age (all P < 0.001), but not with country, sex, or AD dose.

Conclusions: The findings provide a broad picture of contemporary use of MSs with ADs in Asia, support predictions that such treatment increased in recent years, and was associated with diagnosis of bipolar disorder, treatment in inpatient and psychiatric settings, and younger age.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Age Factors
  • Antidepressive Agents / therapeutic use*
  • Antimanic Agents / therapeutic use*
  • Anxiety Disorders / drug therapy
  • Asia
  • Bipolar Disorder / drug therapy*
  • Cross-Sectional Studies
  • Depressive Disorder, Major / drug therapy
  • Drug Prescriptions / statistics & numerical data*
  • Drug Therapy, Combination
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Male
  • Mental Health Services / statistics & numerical data*
  • Middle Aged
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Practice Patterns, Physicians' / trends

Substances

  • Antidepressive Agents
  • Antimanic Agents