Medication adherence and the use of long-acting antipsychotics in bipolar disorder

Rif S El-Mallakh
Journal of Psychiatric Practice 2007, 13 (2): 79-85

BACKGROUND: Adherence to treatment is a major determinant of outcome in bipolar disorder. Poor insight, attitudes towards treatment, and poor understanding of medications and the illness can all lead to reduced adherence. Nonadherence and partial adherence both also appear to play a significant role in relapse. Thirty to forty percent of patients with bipolar disorder who attempt to be adherent to treatment are actually only partially adherent. Clinicians frequently address the problem of poor adherence by adding an antipsychotic medication to the mood stabilizer regimen. The availability of a long-acting atypical antipsychotic raises the possibility of using this agent to prevent bipolar relapse.

METHODS: The literature on the use of depot antipsychotics in bipolar illness is reviewed, based on a search of PubMed and Ovid Medline.

RESULTS: No randomized, controlled trials of depot antipsychotics in bipolar illness have been performed. However, several case series and naturalistic trials that have used first generation agents suggest that depot antipsychotics are effective in reducing relapse in bipolar illness.

CONCLUSIONS: Depot antipsychotics, including long-acting first and second generation agents, can be important adjuncts in the long-term management of bipolar illness. Controlled trials with these agents in bipolar disorder are warranted.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"