Although some previous studies have shown that data for nonadherence among patients with bipolar disorder extends to all medication types, little information is known regarding the relationship between their medication-taking behaviors for psychotropic and nonpsychotropic medications.
To help fill this gap, researchers in the Department of Psychiatry at Case Western Reserve University School of Medicine gathered patient-reported data from 88 patients with type I or type II bipolar disorder who reported psychotropic nonadherence (defined as having missed 20 percent or more of their current bipolar medication treatment for either the past week or month, as assessed by the Tablets Routine Questionnaire). Patients were asked questions regarding the presence or absence of comorbid general medical conditions and depression and mania symptoms, as well as their adherence to prescribed psychotropic and nonpsychotropic medications.
The analysis showed that the median proportion of days with missed doses was 53.6 percent for psychotropic medications compared with 33.93 percent for nonpsychotropic medication. In addition, the researchers found that the presence of more severe psychiatric symptoms was significantly associated with nonadherence to nonpsychotropic medication. The most common drugs taken by the participants to treat comorbid conditions included drugs intended for hypertension, cholesterol, and diabetes.
“Our finding that an individual may adhere to one medication over another suggests that nonadherence is at least in part intentional,” the study’s lead author Jennifer Levin, Ph.D., an assistant professor of psychiatry at Case Western, told Psychiatric News. Levin, a clinical psychologist, hypothesized that the significant difference found between nonadherence to psychotropics and nonadherence to nonpsychotropics may include patients’ fear of notable side effects associated with adhering to psychotropics, patients’ perceiving their symptoms as less severe than than they really are, and stigma associated with taking drugs for mental illness.
Levin concluded that the findings highlight the need for mental health professionals to address issues concerning both mental health and physical health by asking patients about adherence to all their prescribed medications.
To read more about medication adherence among patients with mental illnesses, see the Psychiatric News article "Antipsychotic Nonadherence More Common for Mood Disorders Than Schizophrenia."