Among patients receiving opioid prescriptions for pain, higher opioid doses were associated with increased risk of opioid overdose death.

ObjeCtiveTo study the association between benzodiazepine prescribing patterns including dose, type, and dosing schedule and the risk of death from drug overdose among US veterans receiving opioid analgesics.

No abstract

Nocturnal symptoms are commonly experienced by individuals who report frequent GERD symptoms. In addition, HRQL is significantly impaired in those persons who report frequent GERD symptoms, and HRQL impairment is exacerbated in those who report nocturnal GERD symptoms.

Poor adherence with lithium and anticonvulsant medications has been found to be a common occurrence among individuals with bipolar disorder (estimates range between 20 and 55%) and is often associated with negative clinical outcomes (1-4). A variety of factors such as patient age, marital status, gender, educational level, symptoms, side effects of medications and comorbid substance abuse, as well as environmental factors such as psychosocial support and access to care are known to affect treatment adherence among individuals with bipolar disorder (1, 5-13). Posttraumatic stress disorder (PTSD), not infrequently Objectives: 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 ¼ 73,964).Methods: 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.Results: Approximately 45% (n ¼ 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 nonadherence were younger age, minority ethnicity, comorbid substance abuse and homelessness.Conclusions: 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.