Overcoming Obstacles to Treatment Adherence in Bipolar Disorder

Poor treatment adherence occurs in half or more of individuals with bipolar disorder and is a substantial cause or relapse and poor outcome. Reasons for poor treatment adherence are diverse and include lack of insight about the need for ongoing pharmacotherapy, denial of illness, concerns about actual or perceived side effects, dissatisfaction with medication efficacy, stigma, and negative attitudes about pharmacotherapy in general. Poor treatment adherence also often becomes linked with symptom severity, psychiatric or substance use comorbidities, or impaired psychosocial functioning. This presentation discusses the varied factors that may contribute to poor treatment adherence and provides practical information on strategies to overcome medication nonadherence and optimize clinical outcomes in bipolar disorder.

Joseph F. Goldberg, MD is Clinical Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai, and President of the American Society of Clinical Psychopharmacology. He attended college at the University of Chicago, graduate school in neuroscience at the University of Illinois-Chicago, and medical school at Northwestern University Medical School, then completed his psychiatry training and psychopharmacology research fellowship at the Payne Whitney Clinic of New York Presbyterian Hospital. His research has focused on the clinical phenomenology, treatment and outcome of mood disorders. He has published over 240 peer-reviewed papers on psychopharmacology and mood disorders, as well as five books, most recently “Clinical Reasoning and Decision-Making in Psychiatry” to be published in 2024 by Cambridge University Press. He serves as Deputy Editor of the Journal of Clinical Psychiatry and an Associate Editor for the journal CNS Spectrums. Dr. Goldberg is a Distinguished Life Fellow of the American Psychiatric Association and has been listed for many years in Best Doctors in America and Castle Connolly’s “America’s Top Doctors.”

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