Clinical Features Associated With Poor Pharmacologic Adherence in Bipolar Disorder

Perlis, Roy H.; Ostacher, Michael J.; Miklowitz, David J.; Hay, Aleena C.; Nierenberg, Andrew A.; Thase, Michael E.; Sachs, Gary S.

doi:10.4088/jcp.09m05514yel

Cited by 90 publications

(87 citation statements)

References 40 publications

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“…However, this finding may also imply that longer hospitalizations per se are conducive to treatment adherence after discharge. One can speculate that longer hospitalizations allow a more complete remission, resulting in fewer residual symptoms that may impact adherence negatively (Perlis et al, 2010). Furthermore, longer hospitalizations may facilitate individually tailored pharmacotherapy, improving drug effectiveness and tolerability and thus contributing to a more positive patient attitude towards pharmacotherapy (Velligan et al, 2010;Jonsdottir et al, 2013;Baldessarini et al, 2008b).…”

Section: Discussionmentioning

confidence: 97%

“…Previous studies have shown an association between manic symptoms and non-adherence (Perlis et al, 2010) as well as increased non-adherence in patients that are recovering from mania/hypomania (Baldessarini et al, 2008b). Our findings are likely to reflect the difficulty of managing manic patients in outpatient care, and suggest the need for inpatient care to facilitate proper treatment, an implication further supported by the finding that mania among patients who were diagnosed with bipolar disorder in inpatient care did not predict less prescription fills of prophylactic drugs after discharge.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Predictors for initiation of pharmacological prophylaxis in patients with newly diagnosed bipolar disorder—A nationwide cohort study

Scheen¹,

Brandt²,

Bodén³

et al. 2015

Journal of Affective Disorders

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Predictors for initiation of pharmacological prophylaxis in patients with newly diagnosed bipolar disorder—A nationwide cohort study

Scheen¹,

Brandt²,

Bodén³

et al. 2015

Journal of Affective Disorders

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“…27 In the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study of 1771 patients with at least one follow-up visit, cognitive deficit/memory impairment was the only symptom that was presumably an adverse effect and was significantly linked to nonadherence. 28 Although patients on lithium frequently complain of cognitive impairment, prescribing clinicians should be aware that the cognitive deficits in BD patients can, in part, be a manifestation of the disease itself rather than an adverse effect of lithium. 29 A meta-analysis of 12 studies with lithium treatment concluded that lithium's adverse effect on memory is present but limited.…”

Section: Cognitive Impairmentmentioning

confidence: 99%

Role of Adverse Effects in Medication Nonadherence in Bipolar Disorder

Mago

Borra

Mahajan

2014

Harvard Review of Psychiatry

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Nonadherence to medications is common and associated with poor or limited clinical outcomes in the treatment of bipolar disorder. A review of the literature discloses that adverse effects are one of the commonly reported reasons for nonadherence to mood stabilizers by patients with bipolar disorder. Nevertheless, other than such broad summaries, relatively little attention has been given to the role of adverse effects in relation to nonadherence. This review article is the first to consolidate the available data on this topic. Weight gain, perceived cognitive impairment, tremors, and sedation are the adverse effects most likely to lead to nonadherence. Further research is needed to anticipate, identify, manage, and potentially minimize the impact of adverse effects.

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“…5, [17][18][19] Nonadherence rates can be as high as 79%. [20][21][22] Long-acting injectable (LAI) antipsychotics have the potential to improve medication adherence.…”

mentioning

confidence: 99%

Efficacy and Safety of Aripiprazole Once-Monthly in the Maintenance Treatment of Bipolar I Disorder

Calabrese

Sanchez

Jin

et al. 2017

J. Clin. Psychiatry

114

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Objective: To evaluate efficacy, safety, and tolerability of longacting injectable antipsychotic aripiprazole once-monthly 400 mg (AOM 400) as maintenance treatment for bipolar I disorder (BP-I). Methods: In a double-blind, placebo-controlled, 52-week randomized withdrawal study conducted from August 2012 to April 2016, patients with a DSM-IV-TR diagnosis of BP-I currently experiencing a manic episode were stabilized sequentially on oral aripiprazole and AOM 400 and then randomized to AOM 400 or placebo. The primary end point was time from randomization to recurrence of any mood episode. Other end points included proportion of patients with recurrence of any mood episode and recurrence by mood episode type. Results: Of 266 randomized patients, 64 (48.1%) of 133 in the AOM 400 group and 38 (28.6%) of 133 in the placebo group completed the study. AOM 400 significantly delayed the time to recurrence of any mood episode compared with placebo (hazard ratio: 0.45; 95% CI, 0.30 to 0.68; P < .0001). Significantly fewer patients (P < .0001) experienced recurrence of any mood episode with AOM 400 (35/132; 26.5%) compared with placebo (68/133; 51.1%), with the effects observed predominantly on manic episodes (P < .0001). Patients were not depressed at study entry, and between-group differences in depressive episodes were not significant (P < .864). The treatment-emergent adverse events (incidence > 5%) that were reported at higher rates with AOM 400 than placebo were weight increase, akathisia, insomnia, and anxiety. Conclusions: AOM 400 delayed the time to and reduced the rate of recurrence of mood episodes and was generally safe and well tolerated. These findings support the use of AOM 400 for maintenance treatment of BP-I. Trial Registration: ClinicalTrials.gov identifier: NCT01567527 Clin Psychiatry 2017;78(3):324-331 https://doi.org/10.4088/JCP.16m11201 J

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Clinical Features Associated With Poor Pharmacologic Adherence in Bipolar Disorder

Abstract: Risk for poor medication adherence can be estimated and may be useful in targeting interventions.

Cited by 90 publications

References 40 publications

Predictors for initiation of pharmacological prophylaxis in patients with newly diagnosed bipolar disorder—A nationwide cohort study

Predictors for initiation of pharmacological prophylaxis in patients with newly diagnosed bipolar disorder—A nationwide cohort study

Role of Adverse Effects in Medication Nonadherence in Bipolar Disorder

Efficacy and Safety of Aripiprazole Once-Monthly in the Maintenance Treatment of Bipolar I Disorder

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