Pharmacotherapy exposure as a marker of disease complexity in bipolar disorder: Associations with clinical & genetic risk factors

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dc.coverageDOI: 10.1016/j.psychres.2023.115174
dc.creatorSanchez Ruiz, Jorge A.
dc.creatorCoombes, Brandon J.
dc.creatorPendegraft, Richard S.
dc.creatorOzerdem, Aysegul
dc.creatorMcElroy, Susan L.
dc.creatorCuellar-Barboza, Alfredo B.
dc.creatorPrieto, Miguel L.
dc.creatorFrye, Mark A.
dc.creatorWinham, Stacey J.
dc.creatorBiernacka, Joanna M.
dc.date2023
dc.date.accessioned2025-11-18T19:42:29Z
dc.date.available2025-11-18T19:42:29Z
dc.description<p>Individuals with bipolar disorder (BD) require chronic pharmacotherapy, typically including medication switches or polypharmacy due to persisting symptoms or intolerable side effects. Here, we quantified pharmacotherapy exposure (PE) of Mayo Clinic BD Biobank participants using the number of cross-sectional (at enrollment) and lifetime BD-specific medications and medication classes, to understand the relationship between PE and markers of disease severity or treatment failure, psychiatric comorbidities, and polygenic risk scores (PRS) for six major psychiatric disorders. Being female (p &lt; 0.05), older (p &lt; 0.01), having history of suicide attempts (p &lt; 0.0001), and comorbid attention-deficit/hyperactivity disorder (p &lt; 0.05) or generalized anxiety disorder (p &lt; 0.05) were uniformly associated with higher PE. Lifetime exposure to unique medication classes among participants with BD-I was significantly lower than for those with schizoaffective disorder (estimate = -2.1, p &lt; 0.0001) while significantly higher than for those with BD-II (estimate = 0.5, p &lt; 0.01). Further, higher PRS for schizophrenia (SCZ) and anxiety resulted in greater lifetime medication counts (p &lt; 0.01), both driven by antipsychotic (p &lt; 0.001) and anxiolytic use (p &lt; 0.05). Our results provide initial evidence of the utility of PE as a measure of disease complexity or treatment resistance, and that PE may be predicted by higher genetic risk for SCZ and anxiety.</p>eng
dc.descriptionIndividuals with bipolar disorder (BD) require chronic pharmacotherapy, typically including medication switches or polypharmacy due to persisting symptoms or intolerable side effects. Here, we quantified pharmacotherapy exposure (PE) of Mayo Clinic BD Biobank participants using the number of cross-sectional (at enrollment) and lifetime BD-specific medications and medication classes, to understand the relationship between PE and markers of disease severity or treatment failure, psychiatric comorbidities, and polygenic risk scores (PRS) for six major psychiatric disorders. Being female (p &lt; 0.05), older (p &lt; 0.01), having history of suicide attempts (p &lt; 0.0001), and comorbid attention-deficit/hyperactivity disorder (p &lt; 0.05) or generalized anxiety disorder (p &lt; 0.05) were uniformly associated with higher PE. Lifetime exposure to unique medication classes among participants with BD-I was significantly lower than for those with schizoaffective disorder (estimate = -2.1, p &lt; 0.0001) while significantly higher than for those with BD-II (estimate = 0.5, p &lt; 0.01). Further, higher PRS for schizophrenia (SCZ) and anxiety resulted in greater lifetime medication counts (p &lt; 0.01), both driven by antipsychotic (p &lt; 0.001) and anxiolytic use (p &lt; 0.05). Our results provide initial evidence of the utility of PE as a measure of disease complexity or treatment resistance, and that PE may be predicted by higher genetic risk for SCZ and anxiety.spa
dc.identifierhttps://investigadores.uandes.cl/en/publications/cfd92ab4-0ea7-4136-b045-1b2d2abdd875
dc.identifier.urihttps://repositorio.uandes.cl/handle/uandes/52372
dc.languageeng
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.sourcevol.323 (2023)
dc.subjectBipolar disorder
dc.subjectMental health
dc.subjectPatient reported outcome measures
dc.subjectPolygenic risk score
dc.subjectPsychopharmacology
dc.subjectSDG 3 - Good Health and Well-being
dc.titlePharmacotherapy exposure as a marker of disease complexity in bipolar disorder: Associations with clinical &amp; genetic risk factorseng
dc.typeArticleeng
dc.typeArtículospa
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