The association between concurrent psychotropic medications and self-reported adherence with taking a mood stabilizer in bipolar disorder

Department of Psychiatry and Psychotherapy, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Human Psychopharmacology Clinical and Experimental (Impact Factor: 2.19). 03/2010; 25(1):47-54. DOI: 10.1002/hup.1077
Source: PubMed


Multiple psychotropic medications are routinely prescribed to treat bipolar disorder, creating complex medication regimens. This study investigated whether the daily number of psychotropic medications or the daily number of pills were associated with self-reported adherence with taking a mood stabilizer.
Patients self-reported their mood and medications taken daily for about 6 months. Adherence was defined as taking at least one pill of any mood stabilizer daily. Univariate general linear models (GLMs) were used to estimate if adherence was associated with the number of daily medications and the number of pills, controlling for age. The association between mean daily dosage of mood stabilizer and adherence was also estimated using a GLM.
Three hundred and twelve patients (mean age 38.4 +/- 10.9 years) returned 58,106 days of data and took a mean of 3.1 +/- 1.6 psychotropic medications daily (7.0 +/- 4.2 pills). No significant association was found between either the daily number of medications or the daily number of pills and adherence. For most mood stabilizers, patients with lower adherence took a significantly smaller mean daily dosage.
The number of concurrent psychotropic medications may not be associated with adherence in bipolar disorder. Patients with lower adherence may be taking smaller dosages of mood stabilizers.

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Available from: Greg Murray, Oct 17, 2014
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    • "It is noteworthy that over 80% of the patients with a stable combination were taking three or less drugs. A relatively small number of drugs may facilitate long-term use, and there may be an upper limit on the number of daily drugs beyond which adherence decreases (Bauer et al. 2009; Robertson et al. 2008). Polypharmacy regimens that require frequent dosing, have dietary or time requirements, or are expensive may contribute to nonadherence (Cramer et al. 1989; Ingersoll and Cohen 2008). "
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