For Bipolar Patients, Medication Compliance Is Difficult
As a teenager, I fought my mother and the medication.
In my 20’s, it is hard to keep up with the large doses my doctor prescribes me.
I have been incredibly stable and happy for a long time—for the most part. Because I have occasional mood swings, my doctor wants to see evidence of stability for an even more extended period before she will consider reducing the 10 pills I take each day.
I feel trapped. I don’t want to take them, but she wants me to. I respect her opinion, but I can’t do this.
And so, I confess. I am on my own doses—and I have been, for a couple of months now.
I have a lot of medication in my cupboard because I haven’t been taking the “correct” amount.
Now, I don’t have to go back to the doctor for a while. I don’t have to argue with her and tell her what I’ve been doing, at least for another month or two.
She will catch me.
“Isn’t it a bit unnerving that doctors call what they do “practice”?” –George Carlin
There are a myriad of reasons for medication non-compliance, and the reasons can change depending on the treatment combination.
My medication makes me ill—horrible stomach issues, nausea.
I feel like I am living in quicksand.
Now I have a strong aversion for putting the pills down my throat.
Five in the morning, five at night. Every single day.
I’m not going to pop that many pills in public. Besides, I cannot keep up with that much medication. My mind is everywhere and I have too much to do.
I fear for my health, too.
Surely, there is another way.
According to a recent Finnish study, over half of patients with bipolar disorder fail to take their medication as prescribed.
I sigh with relief. It’s not just me.
The Study Explained
A total of 191 patients were observed for 18 months.
The most frequently prescribed medications were mood stabilizers and antipsychotics; many patients also received psychotherapy.
Over 40 percent of patients who took mood stabilizers exhibited issues with medication compliance, while over 60 percent discontinued antipsychotic drugs.
Reasons for Non-Compliance
The most common reasons for non-compliance were side effects, lack of motivation, and a negative attitude toward a particular treatment.
Furthermore, multivariate models found that predictors of non-compliance were specific to the treatment:
Antipsychotics: Substance dependence, negative attitudes to antipsychotics, and borderline personality disorder were all factors in discontinuation of medication.
Mood Stabilizers: Negative attitudes to mood stabilizers and anxiety disorder.
The study illustrates the importance of patient attitude in medication compliance.
What I’m Saying
Factors like side effects, practicality, and lifestyle all have an effect on medication compliance—because they affect attitude toward treatment.
My meds make me feel sick. I have a lot, at 25, that I need and want to do—I’m a wife, employee, aunt, board member, writer, advocate, and friend.
My life is too busy and too erratic to be taking five pills, twice a day. Even more importantly, I don’t understand why I’m taking the maximum doses of medications right now. Doesn’t make sense to me.
I am still taking a lower dose, which I found to be effective. If my psychiatrist and I could reach a common ground in the treatment plan, I will be more likely to take my medication.
I don’t want to be completely non-compliant, but, I want my clinician to work with me.
Perhaps clinicians do not tap into the practical expertise of the person taking the medication. I have been on medication for mental disorders for 13 years, and I know what works for me and does not work for me.
Treatment needs to be a conversation.
How is your treatment plan going? Do you agree with the medication type and dose that you are on? Would you change it if you could?
Source: Lyford , J. (2013, November 19). Bipolar disorder treatment nonadherence needs more attention. Retrieved from http://www.news-medical.net/news/20131119/Bipolar-disorder-treatment-nonadherence-e28098needs-more-attentione28099.aspx
Dawkins, K. (2013). For Bipolar Patients, Medication Compliance Is Difficult. Psych Central. Retrieved on May 27, 2015, from http://blogs.psychcentral.com/bipolar-life/2013/11/medication-compliance/