Investigation Of Drug Therapy For Bipolar Disorders Patients In Henan Province Mental Hospital In 2014

BackgroundBipolar disorder is a chronic disease of unknown etiology,recurrent,progressive mental illness,and some patients may develop into a mental disability.Therefore,the treatment of bipolar disorder has been the focus of attention to the field of psychiatry,receiving increasing concerns by domestic and foreign scholars.At present,the relevant manuals of bipolar disorder diagnosis and treatment have been published in many countries.In 2015,our country also updated Bipolar Disorder Prevention Guide and standardized its treatment.Drug treatment is still a major way for bipolar disorder,however,there is less study on whether conform to the requirements of the guide for clinical application of medications.This study aims to investigate the current status of medication by analysing medication utilization statistics in patients with bipolar disorder in our hospital in 2014.ObjectiveTo understand the current status of using the medicine on bipolar disorder patients in our hospital and provide the basis for clinical rational drug use combined with Bipolar Disorder Prevention Guide.MethodsEight hundred and twenty-seven patients with bipolar disorder were selected from Henan psychiatric hospital in 2014,whose diagnosis met diagnostic criteria of the tenth edition of International Statistical Classification of Diseases.The current medication utilization was analyzed by medication list and medical records.Combined with the China bipolar disorder prevention guide(secong edition)drug treatment recommendations,normative and rationality analysis of clinical drug use Results1.Of 827 cases of hospitalized patients,513 males(62.0%)and 314 females(38.0%),hospitalized for an average of 43+22 days.On the hospital diagnosis,635 cases met bipolar manic episode,192 cases of bipolar depression.There were 9.18% of patients accepted MECT therapy,while 39.1% received drugs before hospitalization.2.Medicines for the treatment were based on mood stabilizer and antipsychotics,and antipsychotics were much more often used than mood stabilizers.The frequently used antipsychotics were quetiapine and olanzapine,and the frequently used mood stabilizers were sodium valproate and lithium,while antidepressants with low frequency of use,no more than 1% alone used.The use frequency of benzodiazepines drugs was significantly lower in hospital discharge than that in hospital admission(37.2%vs 54.5%,X~2=49.790,P=0.000).In addition,subsidiary drugs were used more often before discharge than used for hospital admission(66.1%vs 5.2%,X~2=669.272,P=0.000),mainly including β-receptor blockers and liver-protection drug.3.Seven hundred and seventy-four patients in hospitalization(93.6%)and 792 patients discharging(95.8%)had been treated with drug combinations,especially mood stabilizers combined with antipsychotics with significantly high rate in patients in discharging(67.1% vs 76.5%,X~2=18.177,P=0.000).4.Whether the first hospitalization or repeated hospitalization,there were no difference between treatment for the patients in hospitalization and discharging,treated with drug combinations,especially mood stabilizers combined with antipsychotics.5.There was significantly higher rate in patients with bipolar manic episode in discharging treated with antidepressants compared with patients in hospitalization(1.7% vs 0.2%,X~2=8.431,P=0.004),while a significantly low rate in patients with bipolar depressive episode in discharging treated with antidepressants compared with patients in hospitalization(67.7% vs 79.7%,X~2=7.107,P=0.008).These datas showed significant differences of treatment with benzodiazepines in hospitalization between patients with bipolar manic episode and with bipolar depressive episode(51.0 % vs 66.1 %,X~2=13.597,P=0.008),and more significant differences in discharging(29.9 % vs61.5%,X~2=62.734,P=0.000).6.Of 192 patients with bipolar depressive phase,34 patients were diagnosed as manic or mixed episodes of bipolar disorder in discharging;of 104 patients treated with mood stabilizer,12 patients with switching;of 40 patients treated with antidepressants alone or combined with benzodiazepines,11 patients turned switching with significancly high rate of switching(11.5% vs 27.5%,X~2=5.484,P=0.019).ConclusionsThe treatment of bipolar disorder is given priority to combination,and there is different for drug use on admission(acute phase)and at discharge(consolidation phase)in our hospital.These findings including treatment given priority to mood stabilizers combined with antipsychotics,the mood stabilizers as core drug use,the use of high frequency of antipsychotic drugs conforms to the Chinese Bipolar Control Guide Principles.There is also difference between the clinical status of bipolar depressive therapy,the use of antidepressants and combination with benzodiazepines and the guidelines recommend,which remains to be further standardized.