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. 2023 Jul:85:103613.
doi: 10.1016/j.ajp.2023.103613. Epub 2023 Apr 28.

Clinical use of mood stabilizers beyond treatment for bipolar disorder: The REAP-MS study

Chih-Ken Chen  1 , Shu-Yu Yang  2 , Seon-Cheol Park  3 , Ok-Jin Jang  4 , Xiaomin Zhu  5 , Yu-Tao Xiang  6 , Wen-Chen Ouyang  7 , Afzal Javed  8 , M Nasar Sayeed Khan  9 , Sandeep Grover  10 , Ajit Avasthi  10 , Roy Abraham Kallivayalil  11 , Kok Yoon Chee  12 , Norliza Chemi  13 , Takahiro A Kato  14 , Kohei Hayakawa  14 , Pornjira Pariwatcharakul  15 , Margarita Maramis  16 , Lakmi Seneviratne  17 , Kang Sim  18 , Wai Kwong Tang  19 , Tin Oo  20 , Norman Sartorius  21 , Chay-Hoon Tan  22 , Mian-Yoon Chong  23 , Yong Chon Park  24 , Naotaka Shinfuku  25 , Shih-Ku Lin  26
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Free article

Clinical use of mood stabilizers beyond treatment for bipolar disorder: The REAP-MS study

Chih-Ken Chen et al. Asian J Psychiatr. 2023 Jul.
Free article

Erratum in

Abstract

Objective: Mood stabilizers are psychotropic drugs mainly used to treat bipolar disorder in the acute phase or for maintenance therapy to prevent relapse. In clinical practice, mood stabilizers are commonly prescribed for conditions other than bipolar disorder. This study investigated the distribution of mood stabilizer prescriptions for different psychiatric diagnoses and studied differences in the drugs, dosage, and plasma concentration in 10 Asian countries including Taiwan, South Korea, Malaysia, China, Thailand, India, Pakistan, Singapore, Indonesia, and Myanmar.

Methods: Patients prescribed mood stabilizers (lithium, carbamazepine, valproic acid, or lamotrigine) for a psychiatric condition other than bipolar disorder (codes F31.0-F31.9 in the International Classification of Diseases, 10th Edition, Clinical Modification) were recruited through convenience sampling. A website-based data entry system was used for data collection.

Results: In total, 1557 psychiatric patients were enrolled. Schizophrenia, schizotypal, delusional, and other non-mood psychotic disorders (F20-F29, 55.8 %) was the most common diagnosis, followed by non-bipolar mood disorders (F30, F31- F39, 25.3 %), organic mental disorder (F00-F09, 8.8 %), mental retardation (F70-F79, 5.8 %) and anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders (F40-F48, 4.4 %). The most frequently targeted symptoms (>20 %) were irritability (48 %), impulsivity (32.4 %), aggression (29.2 %), anger (20.8 %), and psychosis (24.1 %). Valproic acid was the most frequently used medication.

Conclusions: Clinicians typically prescribe mood stabilizers as empirically supported treatment to manage mood symptoms in patients with diagnoses other than bipolar disorders, though there is on official indication for these disorders. The costs and benefits of this add-on symptomatic treatment warrant further investigation.

Keywords: Bipolar disorder; Mood stabilizer; REAP; Schizophrenia.

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Conflict of interest statement

Declaration of Competing Interest The authors declare no conflict of interest in reporting this study.

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