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Related Experiment Video

Updated: May 7, 2026

Robotically Delivered fMRI-Guided Personalized Transcranial Magnetic Stimulation Therapy for Treatment-Resistant Depression
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Medication adherence in a comparative effectiveness trial for bipolar disorder.

L G Sylvia1, N A Reilly-Harrington, A C Leon

  • 1Massachusetts General Hospital, Boston, MA, USA.

Acta Psychiatrica Scandinavica
|October 15, 2013
PubMed
Summary

Medication adherence in bipolar disorder treatment was high in the Lithium Moderate Dose Use Study (LiTMUS). Most participants consistently took their prescribed lithium, indicating good treatment compliance.

Keywords:
bipolar disordercompliancepsychopharmacology

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Area of Science:

  • Psychiatry
  • Clinical Pharmacology
  • Bipolar Disorder Research

Background:

  • Psychopharmacology is central to bipolar disorder management.
  • Low medication adherence (20-64%) poses a significant challenge in this patient population.
  • The Lithium Moderate Dose Use Study (LiTMUS) investigated adherence in a comparative effectiveness trial.

Purpose of the Study:

  • To examine medication adherence in adults with bipolar I or II disorder during a comparative effectiveness study of lithium.
  • To assess the rate of adherence to adjunctive moderate-dose lithium therapy.

Main Methods:

  • A 6-month, six-site randomized effectiveness trial involving 283 adult outpatients.
  • Medication adherence was measured using the Tablet Routine Questionnaire at each study visit.
  • Compared adjunctive moderate-dose lithium therapy with optimized treatment.

Main Results:

  • Baseline non-adherence was 4.50%, remaining below 7% throughout the trial.
  • Poor adherence correlated with increased manic symptoms, side effects, and lower lithium serum levels.
  • No association was found between poor adherence and quality of life, illness severity, or depressive symptoms.

Conclusions:

  • Participants in the LiTMUS trial demonstrated high medication adherence.
  • The study suggests that factors like depression and quality of life may not be strong predictors of adherence in this context.
  • Limitations include potential lack of variance in predictors and the use of a subjective adherence measure.