Misprescribing Antidepressants 07/06/2009 Global ++Antidepressants Not Recommended in Mania but Frequently Prescribed: Research Study
 
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       <td width="175"><a href="http://ssristories.drugawareness.org/archive/show030b.php?item=3405">Misprescribing</a></td>
       <td width="200">Antidepressants</td>
       <td width="100">2009-06-07</td>
       <td width="100">Global</td>
       <td width="639"><strong>++Antidepressants Not Recommended in Mania but Frequently Prescribed: Research Study</strong></td>
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Summary:<br><br><div><font size="3">Paragraph four reads:&nbsp; &quot;These subgroup analyses <strong><u>are driven by the high proportion of antidepressants prescribed </u></strong>in this cohort.&quot;<br /><br /><div align="center">Last paragraph reads:&nbsp; <strong><u>&quot;Although antidepressants are not recommended in MS [Mixed States]&nbsp; and PM [Pure Mania]</u></strong>,&nbsp; they were frequently prescribed at baseline and are maintained during the 24 months of follow-up.&quot;<br /><br /><br /></div><a href="http://7thspace.com/headlines/311349/mixed_states_vs_pure_mania_in_the_french_sample_of_the_emblem_study_results_at_baseline_and_24_months___european_mania_in_bipolar_longitudinal_evaluation_of_medication.html">http://7thspace.com/headlines/311349/mixed_states_vs_pure_mania_in_the_french_sample_of_the_emblem_study_results_at_baseline_and_24_months___european_mania_in_bipolar_longitudinal_evaluation_of_medication.html<br /><br /></a><div align="center">To describe the clinical course and treatment patterns over 24 months of patients experiencing an acute manic/mixed episode within the standard course of care.<br /><br />Methods: EMBLEM was a 2-year European prospective, observational study on outcomes of patients experiencing a manic/mixed episode. Adults with bipolar disorder were enrolled within the standard course of care as in/outpatients if they initiated or changed oral medication for treatment of acute mania.<br /><br />After completing 12 weeks of acute phase, patients were assessed every 3-6 months during the maintenance phase. We present the 24 month results, with subgroup analysis for mixed states (MS) and pure mania (PM).<br /><br />These subgroup analyses are driven by the high proportion of antidepressants prescribed in this cohort.<br /><br />Results: In France, 771 patients were eligible for the maintenance phase. 69% of patients completed the follow up over 24 months.<br /><br />The mean age was 45.5 years (sd=13.6) with 57% of women. 504 (66%) patients were experiencing a PM and 262 (34%) a MS at baseline.<br /><br />The main significant differences in MS vs. PM at baseline were: a higher rate of women, and in the previous 12 months, a higher frequency of episodes (manic/mixed and depressive), more suicide attempts, more rapid cycling, fewer social activities and more work impairment.<br /><br />Over the 24 months of follow-up the MS group had a significantly lower recovery than PM (36% vs. 46%, p=0.006).<br /><br />Overall, 42% of all patients were started on monotherapy and 58% on combination therapy; of those 35% and 30% respectively remained on their initial medication throughout the 24 months. At baseline, 36% were treated with an antidepressant, this proportion remains high throughout the follow-up period, with a significantly higher rate for MS vs.<br /><br />PM at 24 months (55% vs. 27%, p&lt;0.001).<br /><br />Conclusion: In this large sample, MS occur frequently (34%), they are more severe at baseline and have a worse functional prognosis than PM.<br /><br />Although antidepressants are not recommended in MS and PM, they were frequently prescribed at baseline and are maintained during the 24 months of follow-up.<br /><br />Author: Jean-Michel AzorinElodie AubrunJordan BertschCatherine ReedStephanie GerardMichael Lukasiewicz<br />Credits/Source: BMC Psychiatry 2009, 9:33<br /></div></font></div> 
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