Regularity of self-reported daily dosage of mood stabilizers and antipsychotics in patients with bipolar disorder
Abstract Background Polypharmacy is often prescribed for bipolar disorder, yet medication non-adherence remains a serious problem. This study investigated the regularity in the daily dosage taken of mood stabilizers and second generation antipsychotics. Methods Daily self-reported data on medication...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2018-05-01
|
| Series: | International Journal of Bipolar Disorders |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40345-018-0118-8 |
| _version_ | 1818520034495954944 |
|---|---|
| author | Maximilian Pilhatsch Tasha Glenn Natalie Rasgon Martin Alda Kemal Sagduyu Paul Grof Rodrigo Munoz Wendy Marsh Scott Monteith Emanuel Severus Rita Bauer Philipp Ritter Peter C. Whybrow Michael Bauer |
| author_facet | Maximilian Pilhatsch Tasha Glenn Natalie Rasgon Martin Alda Kemal Sagduyu Paul Grof Rodrigo Munoz Wendy Marsh Scott Monteith Emanuel Severus Rita Bauer Philipp Ritter Peter C. Whybrow Michael Bauer |
| author_sort | Maximilian Pilhatsch |
| collection | DOAJ |
| description | Abstract Background Polypharmacy is often prescribed for bipolar disorder, yet medication non-adherence remains a serious problem. This study investigated the regularity in the daily dosage taken of mood stabilizers and second generation antipsychotics. Methods Daily self-reported data on medications taken and mood were available from 241 patients with a diagnosis of bipolar disorder who received treatment as usual. Patients who took the same mood stabilizer or second generation antipsychotic for ≥ 100 days were included. Approximate entropy was used to determine serial regularity in daily dosage taken. Generalized estimating equations were used to estimate if demographic or clinical variables were associated with regularity. Results There were 422 analysis periods available from the 241 patients. Patients took drugs on 84.4% of days. Considerable irregularity was found, mostly due to single-day omissions and dosage changes. Drug holidays (missing 3 or more consecutive days) were found in 35.8% of the analysis periods. Irregularity was associated with an increasing total number of psychotropic drugs taken (p = 0.009), the pill burden (p = 0.026), and the percent of days depressed (p = 0.049). Conclusion Despite low missing percent of days, daily drug dosage may be irregular primarily due to single day omissions and dosage changes. Drug holidays are common. Physicians should expect to see partial adherence in clinical practice, especially with complex drug regimens. Daily dosage irregularity may impact the continuity of drug action, contribute to individual variation in treatment response, and needs further study. |
| first_indexed | 2024-12-11T01:32:01Z |
| format | Article |
| id | doaj.art-8f5a2b961bc1440b94d9afc416669e5a |
| institution | Directory Open Access Journal |
| issn | 2194-7511 |
| language | English |
| last_indexed | 2024-12-11T01:32:01Z |
| publishDate | 2018-05-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | International Journal of Bipolar Disorders |
| spelling | doaj.art-8f5a2b961bc1440b94d9afc416669e5a2022-12-22T01:25:20ZengSpringerOpenInternational Journal of Bipolar Disorders2194-75112018-05-01611910.1186/s40345-018-0118-8Regularity of self-reported daily dosage of mood stabilizers and antipsychotics in patients with bipolar disorderMaximilian Pilhatsch0Tasha Glenn1Natalie Rasgon2Martin Alda3Kemal Sagduyu4Paul Grof5Rodrigo Munoz6Wendy Marsh7Scott Monteith8Emanuel Severus9Rita Bauer10Philipp Ritter11Peter C. Whybrow12Michael Bauer13Department of Psychiatry and Psychotherapy, Medical Faculty, University Hospital Carl Gustav Carus, Technische Universität DresdenChronoRecord Association Inc.Department of Psychiatry and Behavioral Sciences, Stanford School of MedicineDepartment of Psychiatry, Dalhousie UniversityDepartment of Psychiatry, University of Missouri Kansas City School of MedicineMood Disorders Center of Ottawa, University of TorontoDepartment of Psychiatry, University of California San DiegoDepartment of Psychiatry, University of MassachusettsMichigan State University College of Human MedicineDepartment of Psychiatry and Psychotherapy, Medical Faculty, University Hospital Carl Gustav Carus, Technische Universität DresdenDepartment of Psychiatry and Psychotherapy, Medical Faculty, University Hospital Carl Gustav Carus, Technische Universität DresdenDepartment of Psychiatry and Psychotherapy, Medical Faculty, University Hospital Carl Gustav Carus, Technische Universität DresdenDepartment of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA)Department of Psychiatry and Psychotherapy, Medical Faculty, University Hospital Carl Gustav Carus, Technische Universität DresdenAbstract Background Polypharmacy is often prescribed for bipolar disorder, yet medication non-adherence remains a serious problem. This study investigated the regularity in the daily dosage taken of mood stabilizers and second generation antipsychotics. Methods Daily self-reported data on medications taken and mood were available from 241 patients with a diagnosis of bipolar disorder who received treatment as usual. Patients who took the same mood stabilizer or second generation antipsychotic for ≥ 100 days were included. Approximate entropy was used to determine serial regularity in daily dosage taken. Generalized estimating equations were used to estimate if demographic or clinical variables were associated with regularity. Results There were 422 analysis periods available from the 241 patients. Patients took drugs on 84.4% of days. Considerable irregularity was found, mostly due to single-day omissions and dosage changes. Drug holidays (missing 3 or more consecutive days) were found in 35.8% of the analysis periods. Irregularity was associated with an increasing total number of psychotropic drugs taken (p = 0.009), the pill burden (p = 0.026), and the percent of days depressed (p = 0.049). Conclusion Despite low missing percent of days, daily drug dosage may be irregular primarily due to single day omissions and dosage changes. Drug holidays are common. Physicians should expect to see partial adherence in clinical practice, especially with complex drug regimens. Daily dosage irregularity may impact the continuity of drug action, contribute to individual variation in treatment response, and needs further study.http://link.springer.com/article/10.1186/s40345-018-0118-8Bipolar disorderMood stabilizersSecond generation antipsychoticsPolypharmacyAdherence |
| spellingShingle | Maximilian Pilhatsch Tasha Glenn Natalie Rasgon Martin Alda Kemal Sagduyu Paul Grof Rodrigo Munoz Wendy Marsh Scott Monteith Emanuel Severus Rita Bauer Philipp Ritter Peter C. Whybrow Michael Bauer Regularity of self-reported daily dosage of mood stabilizers and antipsychotics in patients with bipolar disorder International Journal of Bipolar Disorders Bipolar disorder Mood stabilizers Second generation antipsychotics Polypharmacy Adherence |
| title | Regularity of self-reported daily dosage of mood stabilizers and antipsychotics in patients with bipolar disorder |
| title_full | Regularity of self-reported daily dosage of mood stabilizers and antipsychotics in patients with bipolar disorder |
| title_fullStr | Regularity of self-reported daily dosage of mood stabilizers and antipsychotics in patients with bipolar disorder |
| title_full_unstemmed | Regularity of self-reported daily dosage of mood stabilizers and antipsychotics in patients with bipolar disorder |
| title_short | Regularity of self-reported daily dosage of mood stabilizers and antipsychotics in patients with bipolar disorder |
| title_sort | regularity of self reported daily dosage of mood stabilizers and antipsychotics in patients with bipolar disorder |
| topic | Bipolar disorder Mood stabilizers Second generation antipsychotics Polypharmacy Adherence |
| url | http://link.springer.com/article/10.1186/s40345-018-0118-8 |
| work_keys_str_mv | AT maximilianpilhatsch regularityofselfreporteddailydosageofmoodstabilizersandantipsychoticsinpatientswithbipolardisorder AT tashaglenn regularityofselfreporteddailydosageofmoodstabilizersandantipsychoticsinpatientswithbipolardisorder AT natalierasgon regularityofselfreporteddailydosageofmoodstabilizersandantipsychoticsinpatientswithbipolardisorder AT martinalda regularityofselfreporteddailydosageofmoodstabilizersandantipsychoticsinpatientswithbipolardisorder AT kemalsagduyu regularityofselfreporteddailydosageofmoodstabilizersandantipsychoticsinpatientswithbipolardisorder AT paulgrof regularityofselfreporteddailydosageofmoodstabilizersandantipsychoticsinpatientswithbipolardisorder AT rodrigomunoz regularityofselfreporteddailydosageofmoodstabilizersandantipsychoticsinpatientswithbipolardisorder AT wendymarsh regularityofselfreporteddailydosageofmoodstabilizersandantipsychoticsinpatientswithbipolardisorder AT scottmonteith regularityofselfreporteddailydosageofmoodstabilizersandantipsychoticsinpatientswithbipolardisorder AT emanuelseverus regularityofselfreporteddailydosageofmoodstabilizersandantipsychoticsinpatientswithbipolardisorder AT ritabauer regularityofselfreporteddailydosageofmoodstabilizersandantipsychoticsinpatientswithbipolardisorder AT philippritter regularityofselfreporteddailydosageofmoodstabilizersandantipsychoticsinpatientswithbipolardisorder AT petercwhybrow regularityofselfreporteddailydosageofmoodstabilizersandantipsychoticsinpatientswithbipolardisorder AT michaelbauer regularityofselfreporteddailydosageofmoodstabilizersandantipsychoticsinpatientswithbipolardisorder |