Clinical rationale of mood stabilizers in treating depression: Insights from prescriptions and adherence patterns
Listed in
This article is not in any list yet, why not save it to one of your lists.Abstract
Background
Mood stabilizers, such as lithium and valproate, are infrequently prescribed for unipolar depression despite their proven efficacy in reducing depression-related suicide rates as well as managing migraines. Recognizing their potential benefits, this study aimed to investigate the effects of increased mood stabilizer prescriptions on depression, particularly following initial consultation, and compare these effects among patients with unipolar and bipolar depression variants.
Methods
This retrospective cohort study analyzed data from 300 patients with a diagnosis of depression in 2016, 2019, and 2022 (100 patients per year). Medical records were reviewed to evaluate the regularity of hospital visits and the continuous use of mood stabilizers and antidepressants over 6 months. Patient adherence to hospital visits was used as a treatment success metric. Kaplan–Meier survival analysis and Cox proportional hazards models were applied to evaluate the impact of medication regimens on patient retention during this period.
Results
The prescription rate for mood stabilizers gradually increased from 27% in 2016 to 89% in 2022, primarily driven by lithium prescriptions. Kaplan–Meier and Cox proportional hazards analyses demonstrated improved patient retention regarding hospital visits over 6 months, with mood stabilizers significantly reducing treatment discontinuation in patients with unipolar depression (n=184) over 3 years (hazard ratio: 0.44; 95% confidence interval: 0.24–0.83; p=0.01).
Conclusion
Mood stabilizers, particularly lithium, are effective in patients with unipolar depression as well as in those with bipolar mood disorders. Incorporating mood stabilizers into standard care strategies for unipolar depression warrants further exploration.
