Of 48,028 individuals with an active prescription for a non-antipsychotic mood stabilizer, 7,502 were not included because of a diagnosis of epilepsy, for a study sample of 40,526. A total of 51.3% were Caucasian (N=20,781); 21.0% (N=8,508) were African American, 12.7% (N=5,150) were Latino, 9.5% (N=3,837) were from other racial-ethnic minority groups, and 5.5% (N=2,250) had missing information. A total of 23,196 (57.2%) were women with a mean age of 38.8±14.8 years. The age categories included 3.4% (N=791) <15 years; 61.4% (N=14,236) 15—49 years, and 35.2% (N=8,169) ≥50 years of age. For men, 10.9% (N=1,883) were <15 years, 62.5% (N=10,823) 15—49 years, and 26.7% (N=4,624) ≥50 years. Among 40,526 individuals taking a non-antipsychotic mood stabilizer, 24.0% (N=9,744) had a bipolar disorder, 22.9% (N=9,298) had major depression or dysthymia, 18.7% (N=7,566) had schizophrenia, 8.5% (N=3,458) had an anxiety disorder, 13.3% (N=5,394) had other diagnoses, and 12.5% (N=5,066) were missing data that indicated psychiatric diagnosis. Individuals in the sample had 44,726 active prescriptions for non-antipsychotic mood stabilizers.
In the entire sample, valproate was the most frequently prescribed non-antipsychotic mood stabilizer (N=13,125, 32.3%), followed by gabapentin (N=10,697, 26.4%), lamotrigine (N=6,757, 16.7%), topiramate (N=5,460, 13.5%), lithium (N=5,293, 13.0%), oxcarbazepine (N=2,080, 5.1%), and carbamazepine (N=1,314, 3.2%). Women of childbearing age were less likely to be prescribed valproate compared with similarly aged men (23.4% versus 44.3%, χ2=1,222.4, df=1, p<.001) or women ≥50 years old (23.4% versus 25.8%, χ2=16.2, df=1, p<.001) (Figure 1). Compared with women ≥50 years, childbearing-aged women were more likely be prescribed lithium (12.4% versus 8.1%, χ2=99.6, df=1, p<.001), although less likely compared with similarly aged men (16.9%, χ2=98.5, df=1, p<.001). For women ≥50 years, gabapentin was the most commonly prescribed non-antipsychotic mood stabilizer and was prescribed significantly more often than for younger women (41.9% versus 22.9%, χ2=892.2, df=1, p<.001).