Trajectories of psychotropic drug use patterns in psychiatric inpatients with acute depressive episodes of bipolar disorder: results from a pharmacovigilance program in German-speaking countries from 2007 to 2024.

Overall, 98.5% of inpatients with acute bipolar disorder were treated with psychotropic drugs.

ADD (T1: 78.1% vs T2: 67.6%; prevalence ratios 0.87, CI 0.79-0.95) and AED (T1: 56.7% vs T2: 34.6%; prevalence ratios 0.61, CI 0.51-0.73) use significantly declined, while lithium use remained stable (31.7% from 2007-2024).

Although the mean number of psychotropic drugs per patient decreased (T1: 3.85 vs T2: 3.34, p < 0.001, d=-0.30), complex polypsychopharmacy consisting of ≥3 psychotropic drugs remained prevalent (66.1% of patients during the entire study period).