title: Medication compliance among patients with bipolar disorder and substance use disorder.
abstract: BACKGROUND
  This study examined patterns of medication compliance and reasons for noncompliance among patients with bipolar disorder and substance use disorder.
  
  
  METHODS
  Forty-four patients with current bipolar disorder and substance use disorder were administered a structured interview regarding lifetime compliance with prescribed psychotropic medications.
  
  
  RESULTS
  Patients who were prescribed both lithium and valproate were significantly (p = .03) more likely to report full compliance with valproate than with lithium. Side effects 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 prescribed benzodiazepines, neuroleptics, and tricyclic antidepressants was the use of more medication than prescribed.
  
  
  CONCLUSIONS
  Valproate may have greater acceptability than lithium among patients with bipolar disorder and substance use disorder. Clinicians should also be aware that these patients may take higher doses of medication than prescribed.
authors.affiliation: Alcohol and Drug Abuse Program, McLean Hospital, Belmont, Mass 02178, USA.
authors.forename: R D
authors.initials: RD
authors.lastname: Weiss
authors.forename: S F
authors.initials: SF
authors.lastname: Greenfield
authors.forename: L M
authors.initials: LM
authors.lastname: Najavits
authors.forename: J A
authors.initials: JA
authors.lastname: Soto
authors.forename: D
authors.initials: D
authors.lastname: Wyner
authors.forename: M
authors.initials: M
authors.lastname: Tohen
authors.forename: M L
authors.initials: ML
authors.lastname: Griffin
mesh_terms: D000328:Adult; D001569:Benzodiazepines / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D002220:Carbamazepine / Q000627:therapeutic use; D015897:Comorbidity; D005260:Female; D006801:Humans; D008094:Lithium / Q000627:therapeutic use*; D008297:Male; D010349:Patient Compliance; D011569:Psychiatric Status Rating Scales; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012189:Retrospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D019966:Substance-Related Disorders / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D014635:Valproic Acid / Q000627:therapeutic use*
chemical_list: D001569:Benzodiazepines; D002220:Carbamazepine; D008094:Lithium; D011619:Psychotropic Drugs; D017367:Selective Serotonin Reuptake Inhibitors; D014635:Valproic Acid