Study: Many bipolar patients on four or more meds

A Brown University study of 230 patients with bipolar I disorder whose symptoms were severe enough to warrant admission to a Rhode Island psychiatric hospital in 2010 reveals that more than a third were admitted despite taking four or more psychiatric medications. More

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Study: Many bipolar patients on four or more meds

THE STUDY quantifies a difficult outcome for many patients with this difficult-to-treat disorder, said study lead author Lauren Weinstock, assistant professor of psychiatry and human behavior at the Warren Alpert Medical School of Brown University.
Posted 2/17/14

PROVIDENCE – A Brown University study of 230 patients with bipolar I disorder whose symptoms were severe enough to warrant admission to a Rhode Island psychiatric hospital in 2010 reveals that more than a third were admitted despite taking four or more psychiatric medications.

The study quantifies a difficult outcome for many patients with this difficult-to-treat disorder, said study lead author Lauren Weinstock, assistant professor of psychiatry and human behavior at the Warren Alpert Medical School of Brown University. Weinstock is on staff at Butler Hospital, where the patients were admitted. Those patients accrue a high burden of prescriptions each with their own side effects, often with unknown interactions and with a complexity that can result in not taking the medications as prescribed. This medication burden also includes high overall cost to patients and the healthcare system.

Yet for those patients who came to the hospital, these complex combinations of drugs have not proven sufficiently effective, Weinstock said.

The study, published online Feb. 1, 2014, in the journal Psychiatry Research, also reports the likelihood of a high medication burden was significantly greater for women than men.

“The high rate of complex polypharmacy reflects the enormous challenge of symptom management that we currently face for bipolar disorder,” said Weinstock. “Without many treatment alternatives, this is where we are as a field. It is important for us to advance science and treatment of bipolar disorder so that this medication burden can be minimized for our patients.”

The proportion of women taking an antidepressant (43 percent) was nearly twice that of men (23 percent). The significance of the gender disparities in the study endured even after statistically controlling for depressive symptoms in their diagnosis.

“Women weren’t prescribed more medications just because they were more likely to be depressed,” Weinstock said. “This finding raises the question of what other factors may influence higher rates of polypharmacy among female patients, such as patient or provider characteristics.”

The study does not provide information that could reveal why that is.

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