Objective: To evaluate the changing trends in the treatment of acute mania during hospitalization between 2004 and 2008.
Methods: Data was collected using a form evaluating demographic, clinical and treatment characteristics. Records of 435 patients with bipolar mania who were hospitalized during the year of 2008 from 15 units were included in the study. The data for treatment preferences obtained from the collaborative study on the acute management of bipolar mania in 2004 were compared to the data of the present study.
Results: In 2004, 41.4% of the patients received monotherapy and 55.1% of the patients had polytherapy. Co-therapy was used in only 3.5% of the patients. Haloperidol was the most preferred drug both as monotherapy (46.7%) and as polytherapy (39.4%). The second most preferred medication was lithium. The treatment was administered per os route in 52.9% and parenteral route in 41.2%.
In 2008, in 14.3% of the patients monotherapy was prescribed, and in 54.2% of the patients co-therapy was administered, and in 31.4% of the patients, polytherapy was prescribed. While haloperidol was the most preferred drug (39.9%) in the treatment of acute mania, the second most preferred drug was quetiapine (30.1%). While ECT was preferred in 7.1% of the patients as the first treatment modality in 2004, it was used in only 0.2% of the patients in 2008.
Conclusions: Haloperidol is still the first choice of treatment in acute mania. Atypical antipsychotics replace mood stabilizers. ECT is being less preferred after the use of atypical antipsychotics.