Skip to main content Accessibility help
×
Home
Hostname: page-component-7f7b94f6bd-l8tfn Total loading time: 0.343 Render date: 2022-07-01T06:13:46.653Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "useNewApi": true } hasContentIssue true

4 - Medication adherence

Published online by Cambridge University Press:  06 July 2010

Craig A. Macneil
Affiliation:
ORYGEN Youth Health, University of Melbourne
Melissa K. Hasty
Affiliation:
ORYGEN Youth Health, University of Melbourne
Philippe Conus
Affiliation:
Université de Lausanne, Switzerland
Michael Berk
Affiliation:
University of Melbourne
Jan Scott
Affiliation:
University of Newcastle, New South Wales
Get access

Summary

The major clinical problem in treating manic-depressive illness is not that there are not effective medications – there are – but that patients so often refuse to take them.

Jamison, An Unquiet Mind: A Memoir of Moods and Madness (1995, p. 6)

Medication adherence can be a vital component in the treatment of bipolar disorder, as people who are fully adherent are more likely to achieve syndromal recovery than those who are non-adherent or partially adherent (Keck et al., 1998). In addition, adherence with mood stabilizers such as lithium has been found to significantly reduce the likelihood of attempted or completed suicide in people with mood disorders (Muller-Oerlinghausen et al., 1996; Sachs, 2003; Colom et al., 2005).

Conversely, non-adherence with prescribed medication has been found to influence risk of relapse. For example, a review by Colom et al. (2005) noted that rapid discontinuation of lithium was associated with relapse rates of 50% in the 3 months following cessation, compared with less than 10% in people who continued taking prophylactic medication. Furthermore, Strakowski et al. (1998) noted that 60–80% of people admitted to hospital due to a manic episode had been non-adherent in the previous month.

Unfortunately, poor medication adherence is a longstanding problem in bipolar disorder, and continues to represent a significant challenge. In John Cade's (1949) landmark paper, the first case study he reported was a man whose manic symptoms improved significantly with lithium, following which the man returned to work, ceased medication, and relapsed within 6 weeks.

Type
Chapter
Information
Bipolar Disorder in Young People
A Psychological Intervention Manual
, pp. 55 - 64
Publisher: Cambridge University Press
Print publication year: 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×