Estimated model of psychotropic polypharmacy for bipolar disorder: Analysis using patients' and practitioners' parameters in the MUSUBI study

Naoto Adachi, Takaharu Azekawa, Kouji Edagawa, Eiichiro Goto, Seiji Hongo, Masaki Kato, Eiichi Katsumoto, Toshiaki Kikuchi, Yukihisa Kubota, Kazuhira Miki, Atsuo Nakagawa, Takashi Tsuboi, Hitoshi Ueda, Koichiro Watanabe, Yoichiro Watanabe, Norio Yasui-Furukori, Reiji Yoshimura

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)


Objective: This study aims to clarify the relevant factors influencing practitioners' methods of prescribing medications for bipolar disorder, in a nation-wide survey in Japan. Methods: The clinical records of 3130 outpatients with bipolar disorder were consecutively reviewed from 176 psychiatric outpatient clinics. Fifteen parameters, that is, five patients' including five general characteristics (sex, age, education, occupation, and social adjustment), five patients' aspects of mental functioning (onset age, comorbid mental illness, rapid-cycling, psychopathologic severity, and followed-up years), and five practitioners' characteristics (sex, age, specialist experience, clinic standing years, and location), were evaluated. The number of psychotropic drugs (mood stabilizers, antidepressants, antipsychotic drugs, anxiolytics, and hypnotics) was used as an index of pharmacotherapy. Converted data from each practitioner-unit were analyzed. Results: Seven factors (patient's social adjustment, patient's psychopathology, patient's comorbid mental disorders, patient's followed-up years, doctor's age, clinic running years, and patient's education years) were correlated to the number of psychotropic drugs. Multiple regression analysis showed that the severity of illness (poor social adjustment, and comorbid mental illness) and an intractable disease course (long followed-up years), were significantly associated with the number of psychotropic drugs. Conclusion: Our findings indicated that patient-related conditions affected psychotropic polypharmacy more strongly than did practitioner-related conditions.

Original languageEnglish
Article numbere2764
JournalHuman Psychopharmacology
Issue number2
Publication statusPublished - 2021 Mar


  • bipolar disorder
  • course of disease
  • polypharmacy
  • prescribing manners
  • psychosocial function
  • psychotropic drugs

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Psychiatry and Mental health
  • Pharmacology (medical)


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