Bipolar disorder medication adherence

When is medication indicated in the treatment of psychiatric illness There is no short answer to this question. At one end of the continuum, patients with schizophrenia and other psychotic disorders, bipolar disorder, and severe major depressive disorder should always be considered candidates for pharmacotherapy, and neglecting to use medication, or at least discuss the use of medication with these patients, fails to adhere to the current standard of mental health care. Less severe depressive disorders, many anxiety disorders, and binge eating disorders can respond to psychotherapy and/or pharmacotherapy, and different therapies can target distinct symptom complexes in these situations. Finally, at the opposite end of the spectrum, adjustment disorders, specific phobias, or grief reactions should generally be treated with psychotherapy alone. 

Like many other psychiatric and medical disorders, bipolar disorder is not curable, but it is certainly treatable. Its clinical symptoms can be controlled, modified, and even silenced. Successful treatment must combine drug therapy, psychotherapy, and psychoeducation. More and more frequently, treatment is provided by a team that, at a minimnm, includes a physician—usually a psychiatrist—and a therapist. Whenever possible, treatment should involve the patient s immediate family (sponse, parents, and children). Although medication is the core intervention, it is widely recognized that a number of psychological variables can inflnence the course of the disorder and the patient s adherence to treatment. 

MacDonald L, Chapman S, Syiett M, Bowskill R, Horne R (2016) Improving medication adherence in bipolar disorder a systematic review and meta-analysis of 30 years of intervention trials. J Affect Disord 194 202-221... 

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