PS64. Psychiatrists' thinking about how to prescribe psychotropic drugs in out-patients with major depressive disorder and bipolar disorder in general clinical practice compared to the evidence-based guidelines.

Introduction: For the past few decades there have been many breakthroughs in modern psychiatry, one of which is the usage of atypical antipsychotics (AAP) and mood stabilizers (MS) in bipolar disorder. But the choice of medication has been a subject of debate among doctors worldwide. The goal of this pharmacologic analysis was to characterize the first line medication choice and combination medication choice of bipolar disorder. Methods: We recruited 170 bipolar patients from 2007 to 2013. AAP included risperidone, quetiapine, aripiprazole, olanzapine, amisulpride. MS included valproic acid, lamotrigine, carbamazepine. Antidepressants included selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitor, bupropion, mirtazapine, tricyclic antidepressants. Results: Of 170 patients with bipolar disorder, 60 were diagnosed with depressive episode and 110 with manic episode. Of 60 patients with depressive episode, 7 were given single MS and 6 were given single AAp. 42 were given one AAP and one MS. 2 were given one AAP and two MS. 11 were given two AAP and one MS. 1 was given two AAP and two MS. Of 110 patients with manic episode, 3 were given single MS and 4 were given single AAp. 76 were given one AAP and one MS. 6 were given two AAp. 8 were given one AAP and two MS. 10 were given two AAP and one MS. 3 were given more than two AAP and two MS. Discussion: Our 6 year analysis revealed no differences between AAP (8.7%) and MS (10.1%) as monotherapy. Antidepressants were never used in monotherapy, possibly due to mood switches. In both manic and depressive bipolar patients, the combination therapy of one MS and one AAP was the vast majority (60.9%). This analysis shows that most times, monotherapy isn’t enough to treat the patient and doctors often have to resort to combination therapy. PS64 Psychiatrists’ thinking about how to prescribe psychotropic drugs in out-patients with major depressive disorder and bipolar disorder in general clinical practice compared to the evidence-based guidelines. Maiko Koseki, Tasuku Hashimoto*, Mariko Tsukiji, Daichi Sakurai, Nobuhisa Kanahra, Tadashi Hasegawa, Masaomi Iyo *Presenter Email: [email protected] Chiba University,