Twenty-Three Years of Declining Lithium Use: Analysis of a
                    Pharmacoepidemiological Dataset from German-Speaking Countries

Waldemar Greil; Mateo de Bardeci; Nadja Nievergelt; Sermin Toto; Renate Grohmann; Johanna Seifert; Georgios Schoretsanitis

doi:10.1055/a-2374-2386

Pharmacopsychiatry, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Pharmacopsychiatry 2024; 57(06): 296-303
DOI: 10.1055/a-2374-2386

Original Paper

Twenty-Three Years of Declining Lithium Use: Analysis of a Pharmacoepidemiological Dataset from German-Speaking Countries

Waldemar Greil ^‡

¹Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Germany

²Psychiatric Private Hospital, Sanatorium Kilchberg, Zurich, Switzerland

,

Mateo de Bardeci^‡

²Psychiatric Private Hospital, Sanatorium Kilchberg, Zurich, Switzerland

³Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland

,

Nadja Nievergelt

²Psychiatric Private Hospital, Sanatorium Kilchberg, Zurich, Switzerland

,

Sermin Toto

⁴Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany

,

Renate Grohmann

¹Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Germany

,

Johanna Seifert

⁴Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany

,

Georgios Schoretsanitis

³Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland

⁵The Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, New York, USA

⁶Department of Psychiatry at the Donald and Barbara Zucker School of Medicine at Northwell/Hofstra, Hempstead, NY, USA

› Institutsangaben

Abstract

Introduction Pharmacoepidemiological data suggest that lithium prescriptions for bipolar disorder are gradually decreasing, with less attention having been paid to other indications.

Methods We examined lithium prescriptions between 1994 and 2017 in data provided by the Drug Safety in Psychiatry Program AMSP, including psychiatric hospitals in Germany, Austria and Switzerland. We compared lithium use for different diagnoses before and after 2001 and in three periods (T1: 1994–2001, T2: 2002–2009, and T3: 2010–2017).

Results In a total of 158,384 adult inpatients (54% female, mean age 47.4±17.0 years), we observed a statistically significant decrease in lithium prescriptions between 1994–2000 and 2001–2017 in patients with schizophrenia spectrum disorder from 7.7% to 5.1% and in patients with affective disorders from 16.8% to 9.6%. Decreases in use were also observed for diagnostic subgroups: schizoaffective disorder (ICD-10 F25: 27.8% to 17.4%), bipolar disorder (F31: 41.3% to 31%), depressive episode (F32: 8.1% to 3.4%), recurrent depression (F33: 17.9% to 7.5%, all: p<0.001) and emotionally unstable (borderline) personality disorder (6.3% to 3.9%, p=0.01). The results in T1 vs. T2 vs. T3 were for F25: 26.7% vs. 18.2% vs. 16.2%, F32: 7.7% vs. 4.2% vs. 2.7%, F33: 17.2% vs. 8.6% vs. 6.6% and for F31: 40.8% vs. 31.7% vs 30.0%, i. e. there was no further decrease for lithium use in bipolar disorder after 2002. Lithium’s main psychotropic co-medications were quetiapine (21.1%), lorazepam (20.6%), and olanzapine (15.2%).

Discussion In inpatients, the use of lithium has decreased in patients with bipolar disorder and also with various other psychiatric diagnoses.

Keywords

lithium - pharmacoepidemiology - bipolar disorders - polypharmacy - psychopharmacology

Volltext

Referenzen

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