Long-acting injectable antipsychotic use in patients with bipolar disorder: Findings from the REAP-BD study

Lin C 1 , Lin YP 2 , Park SC 3 , Jang OJ 4 , Si TM 5 , Xiang YT 6 Show all authors , Lin HL 7 , Javed A 8 , Sayeed Khan MN 9 , Grover S 10 , Kallivayali RA 11 , Chee KY 12 , Kato TA 13 , Pariwatcharakul P 14 , Maramis M 15 , Seneviratne L 16 , Sim K 17 , Tang WK 18 , Oo T 19 , Sartorius N 20 , Tan CH 21 , Mian-Yoon 22 , Shinfuku N 23 , Lin SK 24

Affiliations 

  • 1 Kunming Prevention and Control Center, Taipei City Hospital and Psychiatric Center, Taipei, Taiwan
  • 2 Department of Psychiatry, Taipei City Hospital and Psychiatric Center, Taipei, Taiwan
  • 3 Department of Psychiatry, Hanyang University Guri Hospital, Guri, Republic of Korea; Department of Psychiatry, Hanyang University College of Medicine, Seoul, Republic of Korea
  • 4 Department of Psychiatry, Bugok National Hospital, Changyeong, Republic of Korea
  • 5 Peking University Sixth Hospital, Beijing, China
  • 6 Unit of Psychiatry, Department of Public Health and Medicinal Administration, Faculty of Health Sciences & Centre for Cognitive and Brain Sciences, University of Macau, Macao
  • 7 Department of Psychiatry, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
  • 8 Pakistan Psychiatric Research Centre, Fountain House, Lahore, Pakistan
  • 9 Department of Psychiatry, Services Hospital, Lahore, Pakistan
  • 10 Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  • 11 Pushpagiri Institute of Medical Sciences, Tiruvalla, India
  • 12 Department of Psychiatry & Mental Health, Tunku Abdul Rahman Institute of Neurosciences, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
  • 13 Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  • 14 Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • 15 Department of Psychiatry, Dr. Soetomo Hospital - Faculty of Medicine, Airlangga University, Surabaya, Indonesia
  • 16 Department of Psychiatry, University of Sri Jayewardenepura, Sri Lanka
  • 17 Institute of Mental Health, Buangkok Green Medical Park, Singapore
  • 18 Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China
  • 19 Mental Health Hospital, Yangon University of Medicine, Yangon, Myanmar
  • 20 Association for the Improvement of Mental Health Programs, Geneva, Switzerland
  • 21 Department of Pharmacology, National University of Singapore, Singapore
  • 22 Health Management International, Singapore; Regency Specialist Hospital, Johor, Malaysia
  • 23 School of Human Sciences, Seinan Gakuin University, Fukuoka, Japan
  • 24 Department of Psychiatry, Taipei City Hospital and Psychiatric Center, Taipei, Taiwan; Department of Psychiatry, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan. Electronic address: sklin@typech.gov.tw
Asian J Psychiatr, 2024 Dec 04;103:104338.
PMID: 39662387 DOI: 10.1016/j.ajp.2024.104338

Abstract

AIMS: This study aimed to assess treatment patterns and the effectiveness of long-acting injectable antipsychotics (LAIs) in patients with bipolar disorder (BD) across various Asian countries. The study focused on comparing the choices of LAIs, other psychotropic medications, and their psychotropic drug load to explore real-world usage and evaluate the potential benefits of LAIs in BD treatment across different countries.

METHODS: A retrospective cohort study was conducted with BD patients diagnosed according to ICD-10-CM codes F31.0 to F31.9 across 13 Asian countries or regions. Data were collected through an online system covering prescriptions for all psychotropic medications including LAIs. The Anatomical Therapeutic Chemical (ATC) Classification System was used to compare medication dosage patterns.

RESULTS: The study analyzed 2029 prescription records for BD, including 103 cases involving LAIs. The highest LAI prescription rates were found in Sri Lanka and Malaysia, with no reported use in Myanmar, India, and Japan. Patients receiving LAIs were younger, more often male, and had higher BMI and drug loads compared to those on oral medications. South Korea and Indonesia showed the highest LAIs drug load. South Korea, Pakistan, and China exhibited the highest total psychotropic drug loads, while Malaysia had the lowest.

CONCLUSIONS: This study is the first to examine LAIs use for BD across Asia. Cross-national differences in LAIs prescriptions and psychotropic drug load highlight variations in treatment practices and healthcare systems. These findings underscore the need for further research and the development of region-specific guidelines to improve BD treatment outcomes.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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