Medication Compliance Among Patients With Bipolar Disorder and Substance Use Disorder

Background: This study examined patterns ofmedication compliance and reasons for noncompliance amongpatients with bipolar disorder and substance use disorder.

Method: Forty-four patients with current bipolardisorder and substance use disorder were administered astructured interview regarding lifetime compliance withprescribed psychotropic medications.

Results: Patients who were prescribed bothlithium and valproate were significantly (p=.03) more likely toreport full compliance with valproate than with lithium. Sideeffects were the most common reason for lithium noncompliance,but were not cited as a reason for valproate noncompliance. Also,a common pattern of noncompliance among patients prescribedbenzodiazepines, neuroleptics, and tricyclic antidepressants wasthe use of more medication than prescribed.

Conclusion: Valproate may have greateracceptability than lithium among patients with bipolar disorderand substance use disorder. Clinicians should also be aware thatthese patients may take higher doses of medication thanprescribed.