Use of injectable antipsychotics in bipolar I disorder

 

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Comment by Diane McIntosh, BSc Pharmacy, MD, FRCPC – Vancouver, British Columbia

Among the many clinical challenges in the management of bipolar I disorder, the need for effective treatments that maintain symptomatic remission and promote long-term adherence is paramount. Depending on the study population and the methodology employed, up to 60% of patients diagnosed with bipolar disorder do not adhere to treatment recommendations (Colom et al. Bipolar Disord 2005;7(suppl 5):24-31). A recent study reported that patients with bipolar disorder missed doses a mean of three days in the preceding week (Levin et al. J Nerv Ment Dis 2017;205:182-187). Treatment nonadherence is a major risk factor for relapse, readmission to hospital and suicidality (Rascati et al. Psychiatr Serv 2011;62:1032-1040) and is associated with higher rates of work absenteeism and disability (Bagalman et al. J Occup Environ Med 2010;52:478-485).

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