What You Can Do
Try these suggestions if you find your mood slipping and depression symptoms returning, despite taking antidepressants:
- Take your medicine as prescribed. Its common for patients to stop taking their medicine or to reduce the dosage, thinking they can get by on less, Dr. Anable says. This is not a cold or flu that is treated and gone. Its a lot like diabetes or high blood pressure, something you have to deal with a long time.
He cautions against changing your medication unless you talk with your health care provider. To get the maximum benefit from your antidepressant, he suggests, Its important to take your medicine at the same time every day. Either in the morning when you get up or at night when you go to bed is a good idea. Routine makes missing a does less likely and better regulates the medicine in your system.
- Avoid excessive use of alcohol and other drugs. Depression and substance abuse often go together and need to be treated simultaneously, Dr. Anable says. If you are struggling at all while taking antidepressants, try giving up alcohol. Any type of substance abuse alcohol or drugs changes the chemicals in the brain, making it harder for antidepressants to work.
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Concurrent Alcohol Or Drug Abuse
The second most important reason for medication nonadherence in individuals with schizophrenia and bipolar disorder is concurrent substance abuse. This association has been reported in at least 10 studies .8 In one such study, it was found that “substance-abusing patients with schizophrenia were 13 times more likely than non-substance-abusing patients to be noncompliant with antipsychotic medication.”9
Among the reasons for this association is the fact that psychiatrists often tell patients to not drink alcohol when on medication , and the fact that some medications counteract the effects of the alcohol or drugs .
Reasons Bipolar Patients Don’t Take Their Meds
WEDNESDAY, May 19, 2021 — Not taking prescribed medications can lead to relapse, hospitalization and increased risk of suicide for people with bipolar disorder, yet many who have this condition do not take their medicines as prescribed.
A new study examines why this happens, finding six key factors that stop people who have bipolar disorder from taking their medications.
The reasons include unpleasant side effects, difficulty in remembering to take the medications, fear of addiction, and preference for an alternative treatment.
A patient’s own beliefs and knowledge about the disorder also play a role, as does a lack of support from friends, family and health care professionals, according to British researchers.
“Bipolar disorder is a mental health condition that causes extreme mood swings that include emotional highs, known as mania or hypomania, and depressive lows,” said lead researcher Asta Ratna Prajapati, a postgraduate researcher at the University of East Anglia’s School of Pharmacy.
“We wanted to better understand what stops people from taking their medication,” Prajapati said in a university news release.
The research team reviewed 57 studies, mostly surveys and interviews, involving nearly 33,000 patients and health care professionals. About 79% of the studies were conducted in the United States and Europe.
More information
The U.S. National Institute of Mental Health has more on bipolar disorder.
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What Else Should I Consider Before Taking Mood Stabilisers
Sex
Pregnancy
If you are thinking of trying for a baby, speak to your doctor about your medication.
Your doctor should give you information about the effects that medications can have during pregnancy.
If you are pregnant and need to take a mood stabiliser speak to your doctor. Some mood stabilisers can cause problems if you take them whilst you are pregnant. It is important that any decision about treatment during pregnancy weighs up the individual risks and benefits.
LithiumTaking lithium during pregnancy can cause heart problems in the foetus. Lithium should be not be taken when you are pregnant if possible.
ValproateValproate can harm an unborn baby. It can cause birth defects such as:
- problems with forming the face and skull, and
- problems forming the limbs, heart, kidney, urinary tract and sexual organs.
It can also cause developmental and learning problems such as:
- being late in learning to walk and talk,
- lower intelligence than other children of the same age,
- poor speech and language skills, and
- memory problems.
Children are also more likely to have autism or autistic spectrum disorders and signs of Attention Deficit Hyperactivity Disorder .
Lamotrigine
Going Off Bipolar Medication
Going off bipolar medication is a bad idea — well, it’s almost always a bad idea. I know why people want to do it. I would suggest that pretty much everyone on bipolar disorder medication has wanted to go off of it multiple times during treatment. This is completely normal and almost unavoidable. In spite of this strong desire, though, going off bipolar medication is almost always a bad idea.
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Others Opinions On Taking Medication For Mental Illness
This doesnt even start to address the assholes that actually tell people with mental illness to get off of their medications. Its hard enough to stay on horrible mental illness medication at the best of times but when there are groups out there that actively tell you youre doing the wrong thing, its even harder. The pressure is very, very real. Scientology, some religions and antipsychiatrists exert this pressure and their heinous advice has harmed many not just people who have become floridly ill once off of medications, but also those around them who have become victims of the untreated mentally ill person.
Keep in mind untrained of under-trained professionals along with peers can also exert this pressure. It certainly has happened that people have gone to others such as a herbalist or counselor or peer supporter or many others to get help only to be told to stop their treatment. This is unacceptable but happens when people dont know what theyre talking about. This, too, is seductive to the person in pain in mental illness treatment.
So the question becomes not, Why do people with mental illness stop taking medication? but, rather, Why do people with mental illness actually stay on medication?
What Happens When You Stop Taking Lithium Abruptly
As far as experts know, no studies have suggested that lithium can cause severe withdrawal symptoms or discontinuation syndrome. For people who do experience symptoms after stopping, it can be hard to determine the underlying cause of those symptoms.
What we do know, however, is that stopping lithium can greatly increase the risk of bipolar disorder episodes recurring especially when you stop abruptly.
According to another
2018 study on 873 people with bipolar disorder who took lithium found that over 50% discontinued their medication during the study period.
Many reported discontinuing because of side effects, psychiatric reasons, and other barriers. There are other reasons people may want to taper off lithium too, such as finding it hard to keep up with taking regular medication.
Whatever the reason you choose to stop taking lithium, the decision is best made under the supervision of a doctor, and heres why:
Even though discontinuing lithium isnt known to cause physical withdrawal, there is a risk that your bipolar disorder symptoms might return so its important to make sure that a doctor is involved and can help support you during the process.
Centers for Disease Control and Prevention .
Some people benefit from medications so much that they are a permanent part of their mental health treatment plan. Other people choose to take medications for a short time as they explore other treatment options for their condition.
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Information Source And Eligibility Criteria
This review was conducted on the basis of recommendations outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.16 English-language articles published between January 1, 2005, and September 10, 2015, in peer-reviewed journals were searched on MEDLINE through PubMed using the following string of key terms: AND AND AND English AND NOT review . Eligible studies reported at least 1 potentially modifiable risk factor/reason for adherence or nonadherence to prescribed antipsychotic medication in patients with schizophrenia, bipolar disorder, or MDD identified during clinical interaction . HCPs included physicians and case managers. Studies reporting only nonmodifiable reasons were excluded. Modifiable reasons include those that can potentially be addressed clinically or through psychosocial intervention, whereas nonmodifiable reasons are those considered to be inherent to the individual . Review articles, editorials, and articles reporting results from method development, such as psychometric properties of an instrument, were also excluded.
Why Bipolar Patients Dont Take Their Meds
Published by Communications
People with bipolar disorder may not take their medication because of side effects, fear of addiction and a preference for alternative treatment according to research from Norfolk and Suffolk NHS Foundation Trust and the University of East Anglia .
Nearly half of people with bipolar disorder do not take their medication as prescribed leading to relapse, hospitalisation, and increased risk of suicide.
A new study, published today, reveals six key factors that stop people taking their medication as prescribed.
These include whether they are experiencing side effects, difficulties in remembering to take medication and a lack of support from family, friends and healthcare professionals.
A patients own beliefs and knowledge about bipolar disorder and its treatment was also found to affect whether or not they take their meds, as well as fear of addiction, and a preference for alternative treatment.
The new study comes from a team of pharmacists, psychiatrists, and experts in behavioural science from NSFT, UEA, Devon Partnership Trust, and the University of Lyon.
Asta Ratna Prajapati, consultant pharmacist at NSFT and a post-graduate researcher at UEAs School of Pharmacy, led the research. The study was funded by a Health Education England / National Institute for Health Research Clinical Doctoral Research Fellowship.
We wanted to better understand what stops people from taking their medication.
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Lithium For Bipolar Disorder
Lithium is the most widely used and studied medication for treating bipolar disorder. It has been used for more than 50 years and helps reduce the severity and frequency of manic states. It may also help relieve bipolar depression.
People with bipolar disorder may take lifelong lithium as maintenance therapy to prevent relapses. Stopping taking lithium significantly increases oneâs chances of experiencing a recurrence of a bipolar episode.
Studies show that lithium can significantly reduce the risk of suicide among people with bipolar disorder. It also helps prevent future manic episodes.
Lithium is a simple salt that acts on a person’s central nervous system. Doctors donât know exactly how lithium works to stabilize mood. However, it helps people with bipolar disorder have more control over their emotions and cope better with the problems of daily life.
When lithium is used as part of maintenance therapy for bipolar disorder, your doctor will want to take regular blood tests during your treatment because it can affect kidney and thyroid function. Blood tests will also help your doctor monitor the level of lithium in your blood. Your doctor will also probably suggest you drink 8-10 glasses of water or fluid a day during treatment and use a normal amount of salt in your food. Both salt and fluid can affect the levels of lithium in your blood, so its important to consume enough every day.
Lack Of Awareness Of The Illness Also Called Anosognosia
Lack of awareness of illness is the single most important reason for nonadherence with medications. In a recent review, 10 of 14 studies that examined awareness of illness and nonadherence in schizophrenia reported that the two are strongly associated.2 The other four studies were carried out in countries in which there is a very high rate of patient adherence to medications because most patients still do whatever the doctor tells them to do this high adherence rate makes it difficult to measure the effects of lack of awareness.3
Other recent studies have also reported a strong association between lack of awareness and medication nonadherence.4 For example, a study of 218 outpatients reported that the correlation between awareness of illness and adherence with medication was highly statistically significant .5
When impaired awareness of illness is compared with other reasons for medication nonadherence, it is invariably found to be the single most important reason.6 This is true for individuals with bipolar disorder as well as for those with schizophrenia.7
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How Can A Therapist Help
Talk therapy, sometimes called psychotherapy, can teach coping strategies and offer patients a chance to discuss their concerns. It can help you recognize the signs and symptoms of an impending manic or depressive episode. Therapy can also help you understand your relationships with friends and family.
The following types of therapy may be particularly helpful with bipolar disorder:
- Cognitive behavioral therapy With CBT, the focus is on changing negative or harmful thought patterns and behaviors. You may also learn strategies for getting the proper amount of sleep. Too much sleep can trigger depressive episodes, but too little can trigger mania. CBT can also help with stress management. Thats important, as stress can trigger bipolar disorder, Dr. Mehta says.
- Interpersonal and social rhythms therapyThe goal with this therapy is to help you develop healthy daily routines, such as waking up, going to bed, and eating at the same times every day. The more regular your schedule, the more likely it is that you will be able to successfully manage bipolar disorder, Dr. Swartz says.
In addition to therapy, you may also want to try a support group. The Depression and Bipolar Support Alliance can help connect you with people near you.
What Happens When You Stop Taking Psychiatric Medication
It might seem like you don’t need the medication anymore, but if you stop taking it, the medicine will leave your body and your symptoms might return. Quitting without consulting your doctor can be life-threatening. Suicide is a serious concern. It can also trigger withdrawal symptoms and relapse of your depression.
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Why Many Don’t Take Their Bipolar Medications
Welcome to our bipolar treatment adherence area. Here, we’ll discuss why people with bipolar disorder stop taking their medications, the effects of that and what can be done to improve medication adherence.
The failure of individuals with bipolar disorder to take prescribed medications is one of the most serious problems in psychiatric care. It often leads to a relapse of symptoms, rehospitalizations, homelessness, incarceration in jail or prison, victimization, or episodes of violence.
The failure to take medication is referred to as medication noncompliance or medication nonadherence the latter is a better term. Nonadherence is also a problem for other medical conditions for which medication must be taken for long periods, including hypertension, diabetes, epilepsy, asthma, and tuberculosis. Nonadherence may be total but is more often partial it has been suggested that partial adherence be defined as a failure to take 30 percent or more of the prescribed medication during the past month.1
Its Hard To Be Dependent On Meds But I Say Look At The Alternative To Medication Noncompliance Ill Choose Meds Every Single Time
A close relative of mine has bipolar disorder: Six months ago he let his prescription run out. I begged him not to stop. And then he got really, really sick and it triggered my mood swings. I cried almost every day over his terrible behavior towards me. I then got up the courage to walk up to the bear in the cave, which is what I called him because he was so mean- I handed him a bottle of meds and said, Take these or our relationship is over. I meant it.
He took them and was better in one week. He said, I didnt want to be dependent on meds. I wanted to just do things on my own. I didnt think it would get so bad.
A few days ago I finally had a stable day. I looked at my meds and had this thought:
I can miss a few pills. Maybe Im well. Maybe the depression will never come back!Say what? It still shocks me how the devious bipolar brain works. Its hard to be dependent on meds. But I say, look at the alternative. Ill choose meds every single time.
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Hamlets Augury: How To Manage Discontinuation Of Mood Stabilizers In Bipolar Disorder
- Free accessFeb 2013
- Open AccessMay 2020
- The SAGE Encyclopedia of Abnormal and Clinical Psychology2017
- The SAGE Encyclopedia of Intellectual and DevelopmentalDisorders2018
- The SAGE Encyclopedia of Abnormal and Clinical Psychology2017
- Edward S. Andrea Michael E. Friedman Fagiolini ThaseHandbook of Mental Health in the Workplace2002
- Improving the Effectiveness of the Helping Professions: An Evidence-Based Approach to Practice2005
- Medical and Psychiatric Issues for Counsellors2007
- The SAGE Encyclopedia of Abnormal and Clinical Psychology2017
Can Women Who Are Pregnant Or Plan To Become Pregnant Take These Medications
This is an important question, considering that half of all patients with bipolar disorder are women. Dr. Mehta says lithium and lamotrigine can be used during pregnancy. But your doctor will need to monitor your blood levels more frequently than before pregnancy. In high doses, lithium and lamotrigine may cause birth defects in a developing fetus.
Your doctor will talk with you about possible risks to the fetus. These need to be considered alongside the risks to you if you stop taking your medication. Overall, Dr. Mehta says, the risks are relatively low, and the benefit of medication can be so great for some patients with bipolar disorder that it may be worth that risk.
Atypical antipsychotics should not be used in pregnancy, because of their tendency to cause birth defects. Certain anticonvulsant medications should also not be taken by pregnant women because of the potential risks the fetus.
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