Abstract
Based on data from the 1997-2016 National Ambulatory Care Surveys, dramatic changes have occurred in the treatment practices of psychiatrists caring for patients with bipolar disorder (1). These trends include an increase in the prescription of antipsychotics from 19.1% to 52.7% and a concomitant decrease in the prescription of mood stabilizers, including a decrease in the use of lithium from 30.4% to 17.6%. Despite equivocal evidence for efficacy together with evidence for potential harm, prescribing of antidepressants rose from 47.0% to 57.5%. And in spite of growing evidence for efficacy, use of psychotherapy fell from 50.9% to 35.7%.
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