Section - Quick Takes

05. Real-World Effectiveness of Pharmacologic Treatments for Bipolar Disorder

Published on March 1, 2024 Certification expiration date: March 1, 2027

Paul Zarkowski, M.D.

Clinical Associate Professor - University of Washington

Key Points

Patients with bipolar disorder are less likely to be hospitalized when they adhere to their medication, particularly long-acting injectable antipsychotics like olanzapine and haloperidol.
Long-acting olanzapine showed the most significant reduction in psychiatric admissions, followed by long-acting haloperidol, clozapine, and levomepromazine. Notably, most oral antipsychotics did not significantly reduce hospital admissions.
The study's findings, derived from a large, real-world sample, underscore the importance of medication adherence in managing bipolar disorder, providing evidence to support existing clinical practices.

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Reading a new study can be gratifying, not necessarily for presenting novel information but for supporting current clinical practices.

Hello, I’m Paul Zarkowski with the Psychopharmacology Institute.

The focus here is a simple yet vital practice pattern: Patients with bipolar disorder are more likely to avoid hospitalization if they adhere to their medication. Although not groundbreaking, this finding is certainly encouraging. Working with patients with multiple comorbidities at a community mental health center, one might question the applicability of studies on carefully selected subjects to our patient population. A study from Finland provides real-world evidence to affirm this. The study encompassed 60,000 subjects, aged 16–65, diagnosed with bipolar disorder from 1996–2018, using data from inpatient care, specialized outpatient care, and registers of sickness absence and disability pensions. It compared psychiatric admissions during periods of taking antipsychotic medication and mood stabilizers against periods without medication, using the PRE2DUP method.

The study

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Learning Objectives:

After completing this activity, the learner will be able to:

Analyze the significance and implications of the study results, particularly in the context of cariprazine's efficacy in treatment-resistant depression.
Evaluate the efficacy and safety of low-dose risperidone in managing postoperative delirium in elderly patients.
Learn about the potential effectiveness of memantine in treating trichotillomania and skin-picking disorder.
Recognize the increased risk of cardiovascular diseases in patients with psychiatric disorders.
Understand the relationship between medication adherence in bipolar disorder and reduced hospitalization rates, focusing on the efficacy of specific medications.

Original Release Date: March 1, 2024

Expiration Date: March 1, 2027

Experts: Scott Beach, M.D., Paul Zarkowski, M.D., Robert Hudak, M.D.

Medical Editor: Melissa Mariano, M.D.

Relevant Financial Disclosures:

None of the faculty, planners, and reviewers for this educational activity have relevant financial relationships to disclose during the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Contact Information: For questions regarding the content or access to this activity, contact us at support@ml-prod.psychopharmacologyinstitute.com

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Participants must complete the activity online during the valid credit period that is noted above.

Follow these steps to earn CME credit:

View the required educational content provided on this course page.
Complete the Post Activity Evaluation for providing the necessary feedback for continuing accreditation purposes and for the development of future activities. NOTE: Completing the Post Activity Evaluation after the quiz is required to receive the earned credit.
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Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians

Credit Designation Statement

Medical Academy designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.