Medication nonadherence in bipolar disorder: a narrative review

Area of Science:

• Psychiatry
• Pharmacology
• Clinical Psychology

Background:

• Bipolar disorder (BD) treatment relies on maintenance medications.
• Medication nonadherence is prevalent in BD, affecting treatment efficacy.
• Nonadherence significantly increases relapse, hospitalization, and suicide attempt risks.

Purpose of the Study:

• To review the challenges and strategies for improving medication adherence in bipolar disorder.
• To highlight the consequences of nonadherence in BD management.
• To outline practical approaches for clinicians to enhance patient adherence.

Main Methods:

• Literature review of studies on bipolar disorder medication adherence.
• Analysis of factors contributing to nonadherence.
• Synthesis of evidence-based strategies for improving adherence.

Main Results:

• Approximately 50% of BD patients exhibit nonadherence to maintenance medications.
• Adverse effects, complex regimens, poor insight, and comorbid substance misuse are key factors.
• Effective strategies include shared decision-making, psychoeducation, reminders, and managing comorbidities.

Conclusions:

• Addressing medication nonadherence is crucial for effective long-term bipolar disorder management.
• A combination of patient-specific, collaborative strategies is necessary.
• Improving adherence can lead to better patient outcomes and reduced healthcare costs.