PRESCRIBING TRENDS OF ANTIDEPRESSANTS IN BIPOLAR DEPRESSION

Background: This study utilizing pharmacoepidemiologic methods and und ertaken to determine the prescribing patterns of antidepressants parti cularly in bipolar depression. Method: From pharmacy records of the Mc Lean Hospital, the number of patients receiving antidepressants and gi ven electroconvulsive therapy (ECT) from June 1, 1987, to May 8, 1993, was determined. We later linked these data bases with patients who we re diagnosed with DSM-III-R bipolar depression (296.5) during the same period of time. Results: During the 6-year period, it was determined that 3829 inpatients had received tricyclic antidepressants (TCAs), 29 81 fluoxetine, 2603 trazodone, 809 bupropion, 743 monoamine oxidase in hibitors (MAOIs), 592 stimulants, 588 sertraline, 48 paroxetine, and 8 94 ECT. There were significant increases over time in prescriptions of MAOIs compared with fluoxetine (chi2 = 14.36, p = .006), and bupropio n compared with TCAs (chi2 = 6.45, p = .04). There was a trend for bup ropion to be prescribed more over time compared with fluoxetine (chi2 = 5.09, p = .08). There were no significant changes in the prescribing of other antidepressants or in the use of ECT. Conclusion: At our cen ter, prescribing of bupropion and MAOIs in bipolar depression has incr eased significantly. This may be related to the reports in the literat ure of the low switch rates to mania with the use of these drugs.