Majority of bipolar patients missing out on the most effective treatments

Published: 14 March 2018

Research led by Glasgow University has found many bipolar patients are on a combination of medication which is out of line with clinical guidelines

Photo of Laura LyallDr Laura Lyall and Professor Daniel Smith recently published the first output from the University of Glasgow’s MRC Mental Health Data Pathfinder Award.

Danny SmithThe paper published in the British Journal of Psychiatry linked data from electronic hospital records and prescribing records in a cohort of 23,135 patients with bipolar disorder from across Scotland, between the years 2009 and 2016. There were two main findings, both of which are highly relevant to current clinical practice.

  • Firstly, about one quarter of patients with bipolar disorder were being prescribed antidepressants as their only medication. This is not recommended in clinical guidelines because antidepressants are not effective for bipolar depression and can make the long term course of the disorder worse rather than better.
  • Secondly, only one in 20 patients were on lithium monotherapy, the gold standard treatment for bipolar disorder. Another key finding was that there was a year-on-year decrease in the use of lithium between 2009 and 2016.

This work was covered widely in the press and it is hoped it will act as a stimulus to more rational prescribing for bipolar disorder in the future.


First published: 14 March 2018