Medication Non-Adherence: An Overlooked Aspect in the Treatment of Bipolar Disorder

Although pharmacotherapy is a cornerstone in effectively managing mood fluctuations in bipolar disorder, adherence to prescribed medications often remains a challenge in the long run, to prevent recurrent episodes and hospitalizations. Nearly half of the patients are known to either discontinue the therapy or fail to follow the prescription schedule consistently. This challenge usually arises due to multifaceted factors including, complicated dosing schedules, poor insight of the disorder, adverse effects and certain social stigmas. Patients with bipolar disorder should be routinely screened for Medication Non-Adherence to differentiate between actual treatment failure due to inefficacy of medicines and non-compliance to these medications. Several scales and methods have been developed, validated and used for the same. Following this, the barriers can be managed by introducing patient-centric approaches that include simplifying treatment regimens based on subjective complaints, educating patients and their family members regarding the benefits and repercussions, as well as making use of digital reminders and other tools. Implementing these strategies requires the collaborative efforts of psychiatrists and pharmacists. While psychiatrists focus on diagnosis and formulate a treatment plan, pharmacists can synergize the efficacy by providing counselling and reviewing medications. Rather than functioning independently, this collaborative approach creates a strong support system that targets all aspects of management and maximizes the benefits of achieving a therapeutic outcome.