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

Chun Lin, Yueh Pin Lin, Seon Cheol Park, Ok Jin Jang, Tian Mei Si, Yu Tao Xiang, Huang Li Lin, Afzal Javed, M. Nasar Sayeed Khan, Sandeep Grover, Roy Abraham Kallivayali, Kok Yoon Chee, Takahiro A. Kato, Pornjira Pariwatcharakul, Margarita Maramis, Lakmi Seneviratne, Kang Sim, Wai Kwong Tang, Tin Oo, Norman SartoriusChay Hoon Tan, Mian-Yoon, Naotaka Shinfuku, Shih Ku Lin

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Article number104338
JournalAsian Journal of Psychiatry
Volume103
DOIs
Publication statusPublished - Jan 2025

Keywords

  • Antipsychotic
  • Bipolar disorder
  • Long-acting injectable
  • Psychotropic drug load
  • REAP

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