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Prescription Trends for Bipolar Disorder With and Without Comorbid Substance Use and Anxiety Disorders: A Global Bipolar Cohort Collaborative Study

Anastasia K. Yocum, Martin Alda, Bruno Aouizerate, V. Aubin, Frank Bellivier, Raoul Belzeaux, Michael Berk, Joanna M. Biernacka, Monika Budde, Katherine E. Burdick, Yun‐Hsuan Chang, Brandon J. Coombes, Philippe Courtet, Nina Dalkner, Claudia Diaz‐Byrd, Caroline Dubertret, Bruno Étain, Giovanna Fico, Janice M. Fullerton, Ophélia Godin, Katherine Gordon‐Smith, Émmanuel Haffen, Dominique Januel, Kamyar Keramatian, Marion Leboyer, Antoine Lefrère, Pierre‐Michel Llorca, Marzieh Majd, Philip B. Mitchell, Benson Mwangi, Emilie Olie, Bronwyn J. Overs, Joanne Petite, Mircea Polosan, Romain Rey, Gloria Roberts, Paul Roux, Ludovic Samalin, Raymund Schwan, Alessandro Serretti, Jair C. Soares, Sarah H. Sperry, Rebecca Strawbridge, Tatjana Stross, Eduard Vieta, Michel Walter, Lana J. Williams, Mon‐Ju Wu, Lakshmi N. Yatham, Allan H. Young, Antoine Yrondi, Giovana B. Zunta‐Soares, Mark A. Frye, Melvin G. McInnis, Balwinder Singh

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71Institutions associées

12Pays d’affiliation

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OBJECTIVES: To investigate pharmacological treatment patterns in individuals with bipolar disorder (BD) with and without comorbid substance use disorder (SUD) and anxiety disorder (AX), we leveraged the Global Bipolar Cohort to analyze cross-regional practices across North America, Europe, and the Pacific. METHODS: Fourteen cohorts contributed aggregate data on pharmacotherapy, demographics, diagnostic subtypes, and comorbidities. Proportional meta-analyses using generalized linear mixed models were conducted to examine prescription trends and identify clinical differences. RESULTS: The sample (N = 11,521) was 60% female and 84% Caucasian. Participants were categorized into four mutually exclusive groups based on comorbidity status: those with comorbid AX only, comorbid SUD only, both AX and SUD, or neither. The AX+SUD subgroup showed higher rates of attention-deficit/hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD), rapid cycling, obesity, and unemployment, reflecting a more severe clinical profile. Regional variations were notable: North American cohorts reported higher prevalence of AX and SUD than European and Pacific cohorts. Antidepressants use for AX were more common in Europe and the Pacific, while North American prescribing patterns were more variable. Benzodiazepine use was high among individuals with SUD across all regions. Lithium and first-generation antipsychotic prescriptions varied, with higher rates observed in Europe. CONCLUSIONS: Findings underscore the heterogeneity of BD and the influence of comorbid AX and SUD on illness burden and treatment. Regional prescribing variations underscore the need for context-specific guidelines. Gaps in data on medication-assisted treatment for SUD point to areas for future research. These insights can support more individualized and effective care for complex BD presentations.

Institutions

University of Michigan Dalhousie University Université de Bordeaux Fondation FondaMental NutriNeuro Centre Hospitalier Charles Perrens Princess Grace Hospital Centre Inserm Université Paris Cité Sorbonne Paris Cité Hôpital Fernand-Widal Centre National de la Recherche Scientifique Université de Montpellier Centre Hospitalier Universitaire de Montpellier Institute for Neurosciences of Montpellier Institut de Génomique Fonctionnelle Barwon Health Deakin University Mayo Clinic Mayo Clinic in Florida LMU Klinikum Ludwig-Maximilians-Universität München New York Psychoanalytic Society and Institute New York State Psychiatric Institute Columbia University National Cheng Kung University Medical University of Graz Hôpital Louis-Mourier Centro de Investigación Biomédica en Red de Salud Mental Universitat de Barcelona UNSW Sydney Swinburne University of Technology Neuroscience Research Australia Université Paris-Est Créteil Institut Mondor de Recherche Biomédicale University of Worcester Sorbonne Université Hôpital de Ville-Évrard University of British Columbia Institut Pascal University of Clermont Auvergne Brigham and Women's Hospital Harvard University Columbia University Irving Medical Center The University of Texas Health Science Center The University of Texas Health Science Center at Houston Macquarie University Centre Hospitalier Universitaire de Grenoble Grenoble Institute of Neurosciences Université Grenoble Alpes Lyon 1 Université Centre de Recherche en Neurosciences de Lyon Communauté urbaine de Lyon Centre Hospitalier Le Vinatier Université de Versailles Saint-Quentin-en-Yvelines Centre de recherche en Epidémiologie et Santé des Populations 82th Hospital of Pla Centre Hospitalier de Versailles Centre d'Études et de Recherches sur les Qualifications Université de Lorraine Università degli Studi di Enna Kore Oasi Maria SS Istituti di Ricovero e Cura a Carattere Scientifico King's College London Hospital Clínic de Barcelona Fundació Clínic per a la Recerca Biomèdica Consorci Institut D'Investigacions Biomediques August Pi I Sunyer Centre Hospitalier Régional Universitaire de Brest Université Toulouse III - Paul Sabatier Université Fédérale de Toulouse Midi-Pyrénées Hôpital Purpan

Sujets associés

Bipolar Disorder and TreatmentSchizophrenia research and treatmentTreatment of Major Depression

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