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Differential core pharmacotherapy in bipolar I versus bipolar II disorder and European versus American patients not in a syndromal episode

Dell’Osso, Bernardoa,,b,,c,,d; Cremaschi, Lauraa,,b; Arici, Chiaraa,,b; Altamura, A. Carloa,,b; Hooshmand, Farnazd; Do, Dennisd; Shah, Salonid; Gershon, Andad; Holsinger, Alexd; Yeon Park, Donge; Miller, Shefalid; Wang, Po W.d; Ketter, Terence A.d

International Clinical Psychopharmacology: January 2020 - Volume 35 - Issue 1 - p 8–18
doi: 10.1097/YIC.0000000000000282
Original Articles

Assess bipolar disorder subtype and treatment location effects on bipolar disorder core pharmacotherapy. Outpatients not in a syndromal episode referred to the University of Milan and Stanford University Bipolar Disorder Clinics were assessed with SCID for the fourth Edition of the Diagnostic and Statistical Manual of Mood Disorders, and the Systematic Treatment Enhancement Program for Bipolar Disorder Affective Disorders Evaluation, respectively. Prevalence and clinical correlates of antidepressant, antipsychotic, and mood stabilizer use, in aggregate and individually, were compared in bipolar I (BDI) versus II (BDII) patients in Milan/Stanford and in Milan versus Stanford patients, stratified by subtype. Milan/Stanford pooled BDI versus BDII patients significantly more often took antipsychotic (69.8 versus 44.8%), mood stabilizers (68.6 versus 57.7%), and valproate (40.1 versus 17.5%), and less often took antidepressants (23.1 versus 55.6%) and lamotrigine (9.9 versus 25.2%). Milan versus Stanford patients (stratified by bipolar disorder subtype) significantly more often took antipsychotic (BDI and BDII), antidepressants (BDII), and valproate (BDII), and less often took lamotrigine (BDI). Research regarding bipolar disorder core pharmacotherapy relationships with bipolar subtype and treatment location is warranted to enhance clinical management.

aDepartment of Biomedical and Clinical Sciences ‘Luigi Sacco’

bDepartment of Mental Health, ASST Fatebenefratelli-Sacco, Università degli Studi di Milano

c‘Aldo Ravelli’ Research Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan Medical School, Milan, Italy

dDepartment of Psychiatry and Behavioral Sciences, Stanford University, California, USA

eDepartment of Psychiatry, Seoul National Hospital, Seoul, Republic of Korea

Received 22 December 2018 Accepted 5 June 2019

Correspondence to Bernardo Dell’Osso, MD, Dipartimento di Scienze Biomediche e Cliniche ‘Luigi Sacco’, ASST Fatebenefratelli-Sacco, Dipartimento di Salute Mentale, Università degli Studi di Milano, Milan, Italy, Tel: 02/39042803; fax: 02/3904; e-mail:

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