Journal
JOURNAL OF AFFECTIVE DISORDERS
Volume 115, Issue 1-2, Pages 262-268Publisher
ELSEVIER
DOI: 10.1016/j.jad.2008.09.012
Keywords
Bipolar disorder; Alcoholism; Patient compliance; Antidepressants
Categories
Funding
- Developing Center for Interventions to Prevent Suicide [AA15630]
- Conte Center for the Neurobiology of Mental Disorders [MH62185, MH 59710]
- Conchita Rabago Foundation
- Harriet and Esteban Vicente Foundation
Ask authors/readers for more resources
Background: We aimed to examine the adequacy of antidepressant treatment and compliance with treatment in bipolar patients with and without alcohol use disorders (AUD). We hypothesize that the adequacy of antidepressant treatment and the compliance with treatment for those with AUD are lower than for those without AUD. Methods: Subjects were 97 patients with current bipolar major depressive episode, 39 (40.2%) with lifetime history of AUD and 58 (59.8%) without AUD. Adequacy of antidepressant medication treatment in the 3 previous months was assessed using the Antidepressant Treatment History Form. Compliance rates were estimated. Results: Rates of inadequate treatment were high in all patients. Bipolar patients with AUD (74.3%) showed higher rates of inadequate antidepressant treatment than those without AUD (67.3%). The proportion of intensive treatment was higher in bipolars without AUD (15.5%) than in those with AUD (2.6%). Median compliance was similar in bipolars with and without AUD. Limitations: We lack serum medication levels to assess the compliance. We do not have data to address the possibility that the presence of AUD adversely affected prescribing practices. Conclusions: Bipolars with AUD had lower rates of adequate treatment than those without AUD, but the two groups were not different in terms of self-reported treatment adherence. The finding that bipolar patients with or without comorbid AUD did not receive adequate treatment is of considerable clinical relevance. It raises the question as to whether inadequate treatment of depression contributes to the high rates of morbidity, and attempted and completed suicides in bipolar patient populations. (C) 2008 Elsevier B.V. All rights reserved.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available