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.
BACKGROUND: We aimed to examine the adequacy of antidepressant treatment and compliance with treatment in bipolarpatients 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. Bipolarpatients 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 bipolarpatients 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 bipolarpatient populations.
Authors: Maria A Oquendo; Enrique Baca-Garcia; Alexei Kartachov; Vadim Khait; Carl E Campbell; Monique Richards; Harold A Sackeim; Joan Prudic; J John Mann Journal: J Clin Psychiatry Date: 2003-07 Impact factor: 4.384
Authors: Gary S Sachs; Andrew A Nierenberg; Joseph R Calabrese; Lauren B Marangell; Stephen R Wisniewski; Laszlo Gyulai; Edward S Friedman; Charles L Bowden; Mark D Fossey; Michael J Ostacher; Terence A Ketter; Jayendra Patel; Peter Hauser; Daniel Rapport; James M Martinez; Michael H Allen; David J Miklowitz; Michael W Otto; Ellen B Dennehy; Michael E Thase Journal: N Engl J Med Date: 2007-03-28 Impact factor: 91.245
Authors: Maria A Oquendo; Dianne Currier; Shang-Min Liu; Deborah S Hasin; Bridget F Grant; Carlos Blanco Journal: J Clin Psychiatry Date: 2010-07 Impact factor: 4.384
Authors: Louise Foley; James Larkin; Richard Lombard-Vance; Andrew W Murphy; Lisa Hynes; Emer Galvin; Gerard J Molloy Journal: BMJ Open Date: 2021-09-02 Impact factor: 3.006
Authors: Vanessa J Marshall; Nnenna Kalu; John Kwagyan; Denise M Scott; Gloria E Cain; Karen Hill; Victor Hesselbrock; Clifford L Ferguson; Robert E Taylor Journal: J Natl Med Assoc Date: 2013 Impact factor: 1.798
Authors: Trine V Lagerberg; Ole A Andreassen; Petter A Ringen; Akiah O Berg; Sara Larsson; Ingrid Agartz; Kjetil Sundet; Ingrid Melle Journal: BMC Psychiatry Date: 2010-01-27 Impact factor: 3.630