Treatment adherence with antipsychotic medications in bipolar disorder

Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Bipolar Disorders (Impact Factor: 4.97). 07/2006; 8(3):232-41. DOI: 10.1111/j.1399-5618.2006.00314.x
Source: PubMed


Atypical antipsychotic medications are a relatively new, increasingly prominent component of the treatment armamentarium for bipolar disorder. Information on adherence with antipsychotics among individuals with bipolar disorder in general, and atypical antipsychotics in particular, is currently quite limited. Using data from the VA National Psychosis Registry, we examined adherence with antipsychotic medications among patients with bipolar disorder (n = 73,964).
Antipsychotic medication adherence among veterans with bipolar disorder was evaluated using the medication possession ratio and categorizing patients into three groups: fully adherent, partially adherent and non-adherent. We compared characteristics of bipolar patients who received versus those who did not receive antipsychotic medication, and also identified predictors of poor adherence with antipsychotic medications.
Approximately 45% (n = 32,993) of all individuals with bipolar disorder were prescribed antipsychotic medication. Individuals who were prescribed antipsychotic medications were younger and more often had comorbid substance abuse or post-traumatic stress disorder compared to individuals with bipolar disorder who were not prescribed antipsychotic medication. Just over half (51.9%) of individuals appear to be fully adherent with antipsychotic medications, while 48.1% of individuals are either partially adherent or non-adherent with antipsychotic medications. Factors associated with treatment non-adherence were younger age, minority ethnicity, comorbid substance abuse and homelessness.
Treatment non-adherence is a major issue for close to half of individuals with bipolar disorder prescribed antipsychotic medication. Additional studies are needed to better understand treatment adherence within the full range of pharmacologic therapies among individuals with bipolar disorder.

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Available from: Marcia Valenstein, Apr 07, 2015
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    • "Individual patients′ adherence often changed during the follow-up; thus, adherence at one time-point does not guarantee adherence at another. While adherence rates were not fully consistent, we found them to be very similar between different mood stabilizers, in accord with many previous studies (Baldessarini et al., 2008; Colom et al., 2000; Gianfrancesco et al., 2006; Sajatovic et al., 2006b, 2007), suggesting that nonadherence is more a question of patient factors. Although correlations between categories of drugs were strong, adherence to one drug does not guarantee adherence to another. "
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    • "Also, since patients are more likely to stick with the treatment of MDE if they perceive their response to the treatment early (Papakostas et al., 2008), SGA response may be perceived as more rapid (whenever occurring), especially by most impulsive (TA À ) cases of acute BD-II depression . Yet it must be highlighted that the inclusion of high rates of sub-threshold mixed cases of BD-II in our sample may have itself concurred to a higher response rate to SGA (Gianfrancesco et al., 2006Gianfrancesco et al., , 2008 Sajatovic et al., 2006). "
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    Full-text · Article · Jul 2013 · Journal of Affective Disorders
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    • "Atypical antipsychotics have become a widely used for the treatment of bipolar disorder. Using data from the Veterans Affairs National Psychosis Registry, Sajatovic and colleagues reported that 45% of subjects with bipolar disorder were on antipsychotics (n = 73,964) as monotherapy or combination therpay.9 The great majority of individuals prescribed antipsychotic agents received atypical compounds (n = 25,559, 94.7%). "
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