Adjunctive Antidepressant Use in Bipolar Disorder and Its Clinical Correlates: An Asian Psychotropic Prescription Patterns Consortium Study
7
Issued Date
2025-06-01
Resource Type
ISSN
17585864
eISSN
17585872
Scopus ID
2-s2.0-105007618885
Journal Title
Asia Pacific Psychiatry
Volume
17
Issue
2
Rights Holder(s)
SCOPUS
Bibliographic Citation
Asia Pacific Psychiatry Vol.17 No.2 (2025)
Suggested Citation
Hu Y., Chew Q.H., Lin S.K., Ouyang W.C., Chen C.K., Park S.C., Jang O.J., Chee K.Y., Ding K.S., Chong J., Zhang L., Li K., Zhu X., Jatchavala C., Pariwatcharakul P., Kallivayalil R.A., Grover S., Avasthi A., Ansari M., Maramis M.M., Paing P.A., Tan C.H., Xiang Y.T., Chong M.Y., Park Y.C., Kato T.A., Shinfuku N., Baldessarini R.J., Sim K. Adjunctive Antidepressant Use in Bipolar Disorder and Its Clinical Correlates: An Asian Psychotropic Prescription Patterns Consortium Study. Asia Pacific Psychiatry Vol.17 No.2 (2025). doi:10.1111/appy.70004 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/110723
Title
Adjunctive Antidepressant Use in Bipolar Disorder and Its Clinical Correlates: An Asian Psychotropic Prescription Patterns Consortium Study
Author(s)
Hu Y.
Chew Q.H.
Lin S.K.
Ouyang W.C.
Chen C.K.
Park S.C.
Jang O.J.
Chee K.Y.
Ding K.S.
Chong J.
Zhang L.
Li K.
Zhu X.
Jatchavala C.
Pariwatcharakul P.
Kallivayalil R.A.
Grover S.
Avasthi A.
Ansari M.
Maramis M.M.
Paing P.A.
Tan C.H.
Xiang Y.T.
Chong M.Y.
Park Y.C.
Kato T.A.
Shinfuku N.
Baldessarini R.J.
Sim K.
Chew Q.H.
Lin S.K.
Ouyang W.C.
Chen C.K.
Park S.C.
Jang O.J.
Chee K.Y.
Ding K.S.
Chong J.
Zhang L.
Li K.
Zhu X.
Jatchavala C.
Pariwatcharakul P.
Kallivayalil R.A.
Grover S.
Avasthi A.
Ansari M.
Maramis M.M.
Paing P.A.
Tan C.H.
Xiang Y.T.
Chong M.Y.
Park Y.C.
Kato T.A.
Shinfuku N.
Baldessarini R.J.
Sim K.
Author's Affiliation
Bugok National Hospital
Pushpagiri Institute of Medical Sciences
Tunku Abdul Rahman Institute of Neurosciences
Hospital Bahagia Ulu Kinta
Hebei Provincial Mental Health Center
Jianan Psychiatric Center
Shu-Zen Junior College of Medicine and Management
Kementerian Kesihatan Malaysia
Institute of Mental Health
Seinan Gakuin University
University of Yangon
Postgraduate Institute of Medical Education and Research, Chandigarh
Hanyang University Guri Hospital
Liaquat University of Medical & Health Sciences
Faculty of Medicine, Prince of Songkla University
Hanyang University College of Medicine
The Affiliated Guangji Hospital of Soochow University
Chang Gung University School of Medicine
Graduate School of Medicine
Beijing Anding Hospital, Capital Medical University
National University of Singapore
Chang Gung Memorial Hospital
Lee Kong Chian School of Medicine
Siriraj Hospital
Taipei City Hospital Taiwan
Harvard Medical School
McLean Hospital
Faculty of Health Sciences
Kaohsiung Medical University
Universitas Airlangga
University of Macau
Pushpagiri Institute of Medical Sciences
Tunku Abdul Rahman Institute of Neurosciences
Hospital Bahagia Ulu Kinta
Hebei Provincial Mental Health Center
Jianan Psychiatric Center
Shu-Zen Junior College of Medicine and Management
Kementerian Kesihatan Malaysia
Institute of Mental Health
Seinan Gakuin University
University of Yangon
Postgraduate Institute of Medical Education and Research, Chandigarh
Hanyang University Guri Hospital
Liaquat University of Medical & Health Sciences
Faculty of Medicine, Prince of Songkla University
Hanyang University College of Medicine
The Affiliated Guangji Hospital of Soochow University
Chang Gung University School of Medicine
Graduate School of Medicine
Beijing Anding Hospital, Capital Medical University
National University of Singapore
Chang Gung Memorial Hospital
Lee Kong Chian School of Medicine
Siriraj Hospital
Taipei City Hospital Taiwan
Harvard Medical School
McLean Hospital
Faculty of Health Sciences
Kaohsiung Medical University
Universitas Airlangga
University of Macau
Corresponding Author(s)
Other Contributor(s)
Abstract
Introduction: Adjunctive antidepressant (AD) use is prevalent for the treatment of bipolar disorder (BD) in many countries, but there is little information about this practice in Asia. Accordingly, we addressed the prevalence, dosing, and clinical correlates of adjunctive AD use with BD in a large Asian sample. Methods: Patients with BD were recruited across 13 Asian sites (PR China, Hong Kong, India, Indonesia, Japan, South Korea, Malaysia, Myanmar, Pakistan, Singapore, Sri Lanka, Taiwan, and Thailand) for this cross-sectional study. We examined differences between patients with versus without adjunctive AD treatment. Multivariable logistic regression was used to identify factors associated with the use of adjunctive AD. Results: Among a total of 2114 adult participants (47.7% men; age 42.4 years [CI: 41.8–43.0]; BMI 25.0 kg/m<sup>2</sup> [24.8–25.2]), the prevalence of AD use averaged 19.8% [18.1–21.6], at a mean imipramine-equivalent dose of 113 [110–116] mg/day. Adjunctive AD use was associated with factors including older age, outpatient status, more depression, suicidal behavior, rapid cycling, and lower doses of MS and antipsychotics (APs). Discussion: Usage of AD treatment for BD in Asia was less than half that reported in Western samples. Such use of AD treatment appeared to be well tolerated but underscores the need for close clinical follow-up to avoid risks of excessive elevation of mood or behavior.