Evidence map›Paper›PMID 41134483›Full record

ArticleInternational journal of bipolar disorders2025

Analysing lithium, quetiapine and valproic acid on social media: an infodemiology study.

Juan Pablo Chart-Pascual, Miguel Angel Alvarez-Mon, Maria Montero-Torres, Francisco J Lara-Abelenda, Julen Marin-Napal, Roberto Rodriguez-Jimenez, Raquel Martínez-Velasco, Iñigo Alberdi-Paramo, Ana Gonzalez-Pinto, Cesar I Fernandez-Lazaro

Abstract read
In one paragraph

Article in International journal of bipolar disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Juan Pablo Chart-PascualDepartment of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK. juan.chart_pascual@kcl.ac.uk.ORCID http://orcid.org/0000-0001-5820-0484
Miguel Angel Alvarez-MonCIBERSAM, Madrid, Spain.
Maria Montero-TorresDepartment of Medicine and Medical Specialities, University of Alcalá, Alcalá de Henares, 28801, Madrid, Spain.
Francisco J Lara-AbelendaDepartment of Signal Theory and Communications and Telematic Systems and Computing, School of Telecommunications Engineering, Rey Juan Carlos University, Madrid, Spain.
Julen Marin-NapalPsychiatry Department, Osakidetza Basque Health Service, Araba University Hospital, Vitoria-Gasteiz, Spain.
Roberto Rodriguez-JimenezCIBERSAM, Madrid, Spain.
Raquel Martínez-VelascoDepartment of Psychiatry and Mental Health, Hospital Universitario Puerta de Hierro, 28222, Madrid, Spain.
Iñigo Alberdi-ParamoInstituto de Psiquiatría y Salud Mental, Hospital Clínico San Carlos de Madrid, Madrid, Spain.
Ana Gonzalez-PintoPsychiatry Department, Osakidetza Basque Health Service, Araba University Hospital, Vitoria-Gasteiz, Spain.
Cesar I Fernandez-LazaroDepartment of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008, Pamplona, Spain.ORCID http://orcid.org/0000-0003-2366-2528

Funding

Comunidad de Madrid P2022/ BMD-7321Eusko Jaurlaritza 2022111054Instituto de Salud Carlos III FIS- PI21/00713Instituto de Salud Carlos III FIS- PI22/00653
6 · The paper itself

Abstract

backgroundAlthough lithium is considered the gold standard for the maintenance treatment of bipolar disorder (BD), its prescription has declined in recent decades. At the same time, second-generation antipsychotics (SGAs), such as quetiapine, and other mood stabilisers such as valproic acid, have been increasingly used. Social media platforms such as X (formerly Twitter) provide real-time insights into public and professional perceptions of these treatments, which may influence their use and adherence.

aimsTo analyse how lithium, quetiapine, and valproic acid have been represented on X, by focusing on user type, engagement levels, and thematic content of tweets.

methodWe conducted a mixed-methods, observational study of tweets published in English and Spanish between 2008 and 2022. Tweets containing the generic or commercial names of lithium, valproic acid, and quetiapine were retrieved and analysed using a validated codebook and semi-supervised machine-learning models. Tweets were categorised by user type and clinical and non-clinical content themes.

resultsAmong the 236,797 analysed tweets, quetiapine was the most frequently mentioned drug (69.4%), followed by valproic acid (19.1%) and lithium (11.5%). Lithium tweets showed the highest engagement (54.0 likes and 18.0 retweets per tweet). Patients mainly focused on quetiapine (47.0%), while healthcare professionals more often discussed lithium (58.1%). Tweets containing clinical content were more common in English (78.0%) than in Spanish (54.7%), especially regarding side effects (53.1% vs 8.2%). Tweets on effectiveness were more frequently discussed in English (48.8%), especially for quetiapine (54.7%), but were less common in Spanish (9.8%). Discussion about drug shortages was more prevalent in Spanish tweets (31.6% vs 0.5%), particularly for valproic acid (55.8%).

conclusionsDespite lithium being the least mentioned drug, it generated the highest level of engagement, particularly among healthcare professionals. In contrast, quetiapine was widely mentioned by patients, which reflects a more socially widespread and, at times, problematic use. These findings highlight the value of listening to conversations on social media to better understand perceptions, concerns, and attitudes that may influence adherence and prescribing trends in mental health.

Identifiers

PMID41134483
PMCPMC12552198

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.