{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T03:14:48Z","timestamp":1790392488149,"version":"4.1.0"},"reference-count":25,"publisher":"Royal College of Psychiatrists","issue":"01","license":[{"start":{"date-parts":[[2018,10,8]],"date-time":"2018-10-08T00:00:00Z","timestamp":1538956800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec id=\"S0007125018002039_sec_a1\"><jats:title>Background<\/jats:title><jats:p>Research on the risk of stroke following the use of mood stabilisers specific to patients with bipolar disorder is limited.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125018002039_sec_a2\"><jats:title>Aims<\/jats:title><jats:p>In this study, we investigated the risk of stroke following the exposure to mood stabilisers in patients with bipolar disorder.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125018002039_sec_a3\" sec-type=\"methods\"><jats:title>Method<\/jats:title><jats:p>Data for this nationwide population-based study were derived from the Taiwan National Health Insurance Research Database. Among a retrospective cohort of patients with bipolar disorder (<jats:italic>n<\/jats:italic>= 19 433), 609 new-onset cases of stroke were identified from 1999 to 2012. A case\u2013crossover study design utilising 14-day windows was applied to assess the acute exposure effect of individual mood stabilisers on the risk of ischaemic, haemorrhagic and other types of stroke in patients with bipolar disorder.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125018002039_sec_a4\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Mood stabilisers as a group were significantly associated with the increased risk of stroke in patients with bipolar disorder (adjusted risk ratio, 1.26;<jats:italic>P<\/jats:italic>= 0.041). Among individual mood stabilisers, acute exposure to carbamazepine had the highest risk of stroke (adjusted risk ratio, 1.68;<jats:italic>P<\/jats:italic>= 0.018), particularly the ischaemic type (adjusted risk ratio, 1.81;<jats:italic>P<\/jats:italic>= 0.037). In addition, acute exposure to valproic acid elevated the risk of haemorrhagic stroke (adjusted risk ratio, 1.76;<jats:italic>P<\/jats:italic>= 0.022). In contrast, acute exposure to lithium and lamotrigine did not significantly increase the risk of any type of stroke.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125018002039_sec_a5\" sec-type=\"conclusion\"><jats:title>Conclusions<\/jats:title><jats:p>Use of carbamazepine and valproic acid, but not lithium and lamotrigine, is associated with increased risk of stroke in patients with bipolar disorder.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125018002039_sec_a6\"><jats:title>Declaration of interest<\/jats:title><jats:p>None.<\/jats:p><\/jats:sec>","DOI":"10.1192\/bjp.2018.203","type":"journal-article","created":{"date-parts":[[2018,10,8]],"date-time":"2018-10-08T10:16:10Z","timestamp":1538993770000},"page":"409-414","source":"Crossref","is-referenced-by-count":28,"title":["Mood stabilisers and risk of stroke in bipolar disorder"],"prefix":"10.1192","volume":"215","author":[{"given":"Pao-Huan","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shang-Ying","family":"Tsai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Hung","family":"Pan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi-Kang","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng-Shiang","family":"Su","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiao-Chicy","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2773-1335","authenticated-orcid":false,"given":"Chian-Jue","family":"Kuo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2018,10,8]]},"reference":[{"key":"S0007125018002039_ref4","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20204"},{"key":"S0007125018002039_ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2013.06.012"},{"key":"S0007125018002039_ref2","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2013.1394"},{"key":"S0007125018002039_ref1","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12331"},{"key":"S0007125018002039_ref27","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.13r08657"},{"key":"S0007125018002039_ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2017.01.004"},{"key":"S0007125018002039_ref25","doi-asserted-by":"publisher","DOI":"10.1097\/PSY.0b013e3181acee26"},{"key":"S0007125018002039_ref24","first-page":"35","volume":"54","year":"1993","journal-title":"J Clin Psychiatry"},{"key":"S0007125018002039_ref23","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02784-7"},{"key":"S0007125018002039_ref22","doi-asserted-by":"publisher","DOI":"10.1177\/0269881107080792"},{"key":"S0007125018002039_ref21","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0055471"},{"key":"S0007125018002039_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.vph.2010.09.004"},{"key":"S0007125018002039_ref18","first-page":"767","volume":"7","year":"2013","journal-title":"Drug Des Devel Ther"},{"key":"S0007125018002039_ref17","doi-asserted-by":"publisher","DOI":"10.1586\/14737175.2014.875471"},{"key":"S0007125018002039_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60441-3"},{"key":"S0007125018002039_ref15","doi-asserted-by":"publisher","DOI":"10.1007\/s11940-010-0080-y"},{"key":"S0007125018002039_ref14","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.23.9.1237"},{"key":"S0007125018002039_ref8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2011.03316.x"},{"key":"S0007125018002039_ref13","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0179424"},{"key":"S0007125018002039_ref7","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1002\/pds.2186","volume":"20","year":"2011","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"S0007125018002039_ref12","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"S0007125018002039_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.pnpbp.2016.06.006"},{"key":"S0007125018002039_ref5","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12336"},{"key":"S0007125018002039_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2012.07.006"},{"key":"S0007125018002039_ref3","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v66n1215"}],"container-title":["The British Journal of Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0007125018002039","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,12]],"date-time":"2020-11-12T07:53:24Z","timestamp":1605167604000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0007125018002039\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10,8]]},"references-count":25,"journal-issue":{"issue":"01","published-print":{"date-parts":[[2019,7]]}},"alternative-id":["S0007125018002039"],"URL":"https:\/\/doi.org\/10.1192\/bjp.2018.203","relation":{},"ISSN":["0007-1250","1472-1465"],"issn-type":[{"value":"0007-1250","type":"print"},{"value":"1472-1465","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,10,8]]}}}