The use of monotherapy with mood stabilisers during bipolar disorder concerns only few patients. Neuroleptics, benzodiazepines and recently the new-generation antipsychotic molecules are widely used as adjuvant therapy to mood stabilizers, indeed beyond the indications held by the guidelines.

Modalities of prescription of psychotropic medication during the first admission and over a three-year follow-up in subjects with bipolar disorder.

Evaluate the adequacy of prescribing practices in naturalistic conditions and international guidelines.

Retrospective study of all first-admitted patients with bipolar disorder in two psychiatric wards of Razi Hospital between 2006 and 2008 and over a three-year follow-up.

Our sample consisted of 72 patients. Over 80% of patients had initially received an incisive antipsychotic drug in combination with mood stabilizer; it was a conventional antipsychotic in 65.3%. Sedative neuroleptics were prescribed in 40.3% of cases with a duration average of 19.21 ± 11.97 months. The combination of two antipsychotic drugs was found in 33.3% of patients. The most frequent association was “haloperidol-chlorpromazine” (79%). Benzodiazepines were prescribed in acute phase in the majority of the sample (94%) with a duration average of 27 mo is ±8.4 months; it was the lorazepam in 70.6%.

Theoretical recommendations do not always reflect the practical situations. Evaluating indications and conditions of polytherapy are critical issues in future studies on the biological treatment of bipolar disorder.