Retrospective Observational Study on Real-World Adult Patients With Bipolar Disorder: Demographic, Comorbidity, and Drug Prescription Profiles

OBJECTIVES: Bipolar disorder (BD) is a chronic mental disorder that affects both adults and children worldwide; however, limited information is available in Saudi Arabia. Consequently, the aims of this study are (1) to identify the characteristics of patients diagnosed with BD in Saudi Arabia and (2) to evaluate the prescribing of medication during the first year after the initial prescription.

METHODS: This multicenter, retrospective, observational study used de-identified electronic health records (EHRs) for all adults (≥18 years) with newly diagnosed BD from 1 January 2015 to 31 December 2023. The data were extracted from the National Pharmacoepidemiologic Database (NPED). Patients were identified using relevant ICD-10-CM diagnostic codes (F31.0–F31.9). Baseline demographic and clinical data were collected. Medication utilization included mood stabilizers, atypical antipsychotics, antidepressants and benzodiazepines.

RESULTS: A total of 1,348 patients with BD were included in the study (mean age 42.3 ± 16.0 years; 60.3% women; 80.8% BD Type I). Those in the 25–34- and 35–44-year age groups were the most common identified patients (25.4% and 18.5%, respectively). Medical comorbidities were present in 21.3% of the patients, with psychiatric comorbidities in 9.4%. Within the first year of diagnosis, 77.6% of the patients-initiated BD treatment. The most used medication classes were antipsychotics (87.8%), antidepressants (35.0%), benzodiazepines (28.3%) and mood stabilizers (21.4%). The most frequent treatment regimen was antipsychotic monotherapy (36.4%). The most frequently prescribed classes of drugs to the same patients were antipsychotic plus antidepressant (28.4%), with a significant gender difference (females, 30.7%, vs. males, 24.7%, p = 0.035).

CONCLUSIONS: The findings highlighted that antipsychotics were the most used medication class. However, there was a relatively low use of mood stabilizers, which is the mainstay of BD management. This finding corroborates with other real-world studies and highlights the need for the potential optimization of prescribing practices for BD.