Clinical prescription of lithium, anticonvulsants antipsychotics, and antidepressants for major mood disorders

Abstract Background As choices of treatments for bipolar disorder types I (BD1) and II (BD2) and major depressive disorder (MDD) continue to evolve, we reviewed studies directly comparing current clinical usage rates of medicinal treatments for these disorders. Methods Comprehensive searching of fiv...

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Main Authors: Carolina Hernandorena, Micaela Dines, Alessandro Miola, Nicolas A. Nuñez, Leonardo Tondo, Ross J. Baldessarini, Gustavo H. Vázquez
Format: Article
Language:English
Published: SpringerOpen 2025-07-01
Series:International Journal of Bipolar Disorders
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Online Access:https://doi.org/10.1186/s40345-025-00381-y
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Summary:Abstract Background As choices of treatments for bipolar disorder types I (BD1) and II (BD2) and major depressive disorder (MDD) continue to evolve, we reviewed studies directly comparing current clinical usage rates of medicinal treatments for these disorders. Methods Comprehensive searching of five literature databases through March 2024 identified reports on clinical drug prescription rates for BD and MDD patients. Rates were summarized and compared by random-effects meta-analyses with R-Studio software. Results A total of 18 reports (2006–2023) supported comparisons of clinically prescribed treatments for 17,572 mood-disorder patients (mean age 42.8 years; 7936 BD1 age 43.2 years; 6309 BD2, age 43.3; 3327 MDD, age 40.0). Among diagnoses: (BD1 vs. BD2 vs. MDD), treatments differed as: lithium (54.4% vs. 38.0% vs. 6.78%), second-generation antipsychotics (41.6% vs. 22.3% vs. 15.9%), valproate (25.7% vs. 21.5%; no MDD data), lamotrigine (13.1% vs. 27.2%; no MDD data), and antidepressants (34.9% vs. 46.4% vs. 77.5%). International use of lithium for BD appeared to increase between 2006 and 2023. Limitations Outcomes were heterogeneous and requiring inclusion of lithium may introduce selection bias. Conclusions Clinical treatment selections for BD1, BD2, and MDD patients differed substantially. Use of modern antipsychotics is undergoing major increases for both BD and MDD; optimal use of antidepressants for BD remains uncertain; and notably, international use of lithium tended to increase in the present data.
ISSN:2194-7511