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Minerva Psichiatrica 2011 March;52(1):1-10

language: Italian

Effectiveness of atypical antipshychotics in a cohort of 206 bipolar patients: five-year retrospective observational study

Lenzi A. 1, Lazzerini F. 2, Simonetti F. 2

1 Dipartimento di Psichiatria, Neurobiologia, Farmacologia e Biotecnologie, Università di Pisa, 56100 Pisa, Italia
2 Azienda USL 1 Massa e Carrara, Dipartimento di Salute Mentale, Massa Carrara, Italia


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aim. The recurrence of illness takes a devastating toll on bipolar patients’ lives. Several randomized controlled trials support the usefulness of atypical antipsychotics (AA) in the longer-term management of bipolar disorders (BD), but many methodological issues could restrict the generalizability of the results. For these reasons, in recent years, effectiveness trials have been launched to address some limitations of efficacy trials. This study evaluated the different effectiveness between four AA in the long-term management of BD.
Methods. We collected the medical records of bipolar patients that received AA in monotherapy or in combination with a mood stabilizer, followed-up for five-years in the Psychiatry Department of Massa Carrara. The outcome measures were discontinuation of treatment for any cause, time until discontinuation and the number of psychiatric hospitalization.
Results. The medical records of 206 patients (95 males and 111 females) were collected: 14 receiving clozapine, 72 olanzapine, 23 quetiapine and 97 risperidone; 56.9% of patients discontinued the starting AA before five years; 51.5% of the AA were used in monotherapy. The mean time until discontinuation was 37.3 months, no significant differences between groups was observed. Medication was changed to about one fifth of the patients during the observation period. The group receiving olanzapine showed significantly lower percentage of suspensions (48.3%) and the group in clozapine showed significantly higher number of admissions.
Conclusion. The long mean duration of treatments and the low rate of discontinuation suggested the effectiveness of AA in the long-term management of BD in monotherapy or in combination with mood stabilizers.

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