Real-world clinical features of and antidepressant prescribing patterns for outpatients with bipolar disorder

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

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)


Background: Several evidence-based practice guidelines have been developed to better treat bipolar disorder. However, the articles cited in these guidelines were not sufficiently based on real-world clinical practice. Methods: The MUlticenter treatment SUrvey on BIpolar disorder in Japanese psychiatric clinics (MUSUBI) is a study conducted to accumulate evidence on the real-world practical treatment of bipolar disorder. Psychiatrists were asked to complete a questionnaire about patients with bipolar disorder by performing a retrospective medical record survey. The questionnaire included patient characteristics (age, gender, height, weight, academic background, and occupational status), comorbidities, mental status, treatment period, Global Assessment of Functioning (GAF) score, and details of pharmacological treatment. Results: Data on 2705 patients were included in this study. The proportion of patients receiving antidepressant prescriptions was 40.9%. The most commonly used antidepressant was duloxetine, and the most frequently used antidepressant class was selective serotonin reuptake inhibitors (SSRIs). Binomial logistic regression analysis and bivariate analysis revealed that the usage of antidepressants was correlated with low prescription rates for mood stabilizers, high prescription rates for anxiolytics and hypnotics, and low GAF scores. In addition, patients in a depressive state had a significantly higher rate of antidepressant prescriptions than patients with other mental states. Conclusions: Approximately 40% of patients in Japan with a diagnosis of bipolar disorder have received antidepressants. Antidepressants were most often prescribed in combination with mood stabilizers, antipsychotics or both. Patients who were prescribed antidepressants received fewer mood stabilizers, more anxiolytics, and more hypnotics than those who did not receive antidepressant prescriptions.

Original languageEnglish
Article number555
JournalBMC Psychiatry
Issue number1
Publication statusPublished - 2020 Dec


  • Antidepressant
  • Bipolar disorder
  • Nationwide study
  • Real world

ASJC Scopus subject areas

  • Psychiatry and Mental health


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