Abstract Details

Title Hospital Utilization Rates Following Antipsychotic Dose Reductions Among Patients With Bipolar and Major Depressive Disorders

Topic Movement Disorders

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 10-027

Objective To analyze the healthcare burden and incidence of TD after antipsychotic dose reduction in patients with BD or MDD.

Background Antipsychotics are commonly used to treat bipolar disorder (BD) and major depressive disorder (MDD). Tardive dyskinesia (TD), an often-irreversible movement disorder, may develop due to antipsychotic exposure, which is often managed with dose reduction. However, the benefits and risks of antipsychotic dose reduction have not been fully described.

Design/Methods Medical claims from six US states spanning 6 years were retrospectively analyzed for ≥10% or ≥30% antipsychotic dose reduction, and compared with those from patients receiving stable doses. Outcomes measured were inpatient admissions and emergency room (ER) visits for BD/MDD, all psychiatric disorders, and all causes. Correlation between antipsychotic dose reduction and the incidence of TD was also evaluated.

Results The analyses included 23,992 patients with BD and 17,766 patients with MDD. Risks of inpatient admission or ER visit for BD (hazard ratio [HR] 1.22; 95% CI 1.15, 1.31; P<0.001), MDD (HR 1.22; 95% CI 1.11, 1.34; P<0.001), and all psychiatric disorders (BD: HR 1.19; 95% CI 1.13, 1.24; P<0.001 and MDD: HR 1.17; 95% CI 1.11, 1.23; P<0.001) were significantly higher vs those who were on stable dose. Risks for all-cause inpatient admission or ER visit were also higher in these patients vs control. The incidence of TD in MDD (Number of events = 18; HR 2.34; 95% CI 1.05, 5.21; P=0.04) or BD (Number of events = 17; HR 1.95; 95% CI 0.90, 4.22; P=0.09) patients who did not have TD at baseline did not decrease with ≥10% antipsychotic dose reduction. Similar patterns were observed in patients with ≥30% antipsychotic dose reduction.

Conclusions Increased risks for hospitalization and ER visit, but not decreased rate of TD incidence, was observed with dose reduction in patients with BD or MDD.

Authors/Disclosures
Benjamin Carroll PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
Sanjay Gandhi, MD (Teva Pharmaceuticals)	Dr. Gandhi has received personal compensation for serving as an employee of Teva Pharmaceuticals.

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