Wednesday, October 5, 2011

Medication Non-compliance is Frustrating For You and Me!

One of the most frustrating situations a clinician encounters is dealing with a client who is habitually non-compliant with their medications.
It's frustrating for me as a clinician because when someone is non-compliant with their medications, they put
 themselves at risk for relapse, decompensation, and possibly hospitalization. I spend a lot of time talking to my patients about medications options, alternatives, and side effects. After spending all of this time with them, I feel cheated when they start to become symptomatic because they didn't take their medications the way I prescribed them. Sometimes patients are honest with me about not taking their medications, other times I find out about their non-compliance when I get the results of their blood work.


Non-compliance comes in several forms:
  • Failing to fill the prescription.
  • Forgetting or choosing not to take the medication.
  • Taking a dose that is too high or too low.
  • Taking the medication at the wrong time of day.
  • Taking the drug only when feeling symptomatic.
Some common reasons for non-compliance are:
  • Unpleasant side-effects from the medication.
  • Not wanting the medication to interfere with the "high" when starting a manic cycle.
  • Feeling that because the symptoms have subsided, there's no need for medication.
  • Difficulty accepting that bipolar disorder is a chronic illness.
The often neglected medicine cabinet
Not taking medication as instructed is one of the most common factors in relapse of the illness. Sometimes people with bipolar disorder don't comply with their treatment because they do not understand the chronic nature of their illness, and sometimes, family members don't understand the illness either.



Your doctor is one of your closest allies in dealing with your illness. Your doctor's goal is to keep you well, and to help you get the most out of life that you can. If you don't like the medications you've been prescribed, or you don't understand why you need to take the medications, the best thing to do is to set up an appointment with your doctor to talk about these issues. Give your doctor the opportunity to help you make to make the best choices concerning the treatment of your bipolar disorder.

2 comments:

  1. Thank you for writing a blog like this. I almost stopped my search on Google and something told me to keep looking. I was diagnosed several months ago and had a hard time accepting it. I have been on Lamotrigine since then. After being stable at 300 mg for 2 months, I started feeling bad. My memory was awful and completing sentences seemed like such a chore. I am actually able to type this more continuously without having to stop every few words. I called my Dr. and said I wanted off of it. He said I would go into a seizure if I abruptly stopped. I have been taking 125 at PM and 150 in the AM. I have been a bit irregular the past week but I definitely feel a lot better. So I am keeping up with this dosage until I see him this weekend. I don't feel 100% and this is scary for me since I am planning on taking the MCAT in March. So my question is do you personally know any physicians with bi-polar?

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  2. Hi PremedBeauty, thanks for posting! Yes, I personally know several physicians with Bipolar Disorder. Ironically, most of the docs I know with Bipolar Disorder have been extremely successful. One of them regularly appears on television, a few others are among the most published doctors I know. Bipolar Disorder can be debilitating for some people, but it certainly doesn't have to be for everyone.

    I understand your frustration, but find the right medication regimen for you, stick with it, reach for the stars and accomplish your goals!

    Good luck!

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