Evidence map›Paper›PMID 29713845›Full record

ArticleInternational journal of bipolar disorders2018

Regularity of self-reported daily dosage of mood stabilizers and antipsychotics in patients with bipolar disorder.

Maximilian Pilhatsch, Tasha Glenn, Natalie Rasgon, Martin Alda, Kemal Sagduyu, Paul Grof, Rodrigo Munoz, Wendy Marsh, Scott Monteith, Emanuel Severus and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of bipolar disorders, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Maximilian PilhatschDepartment of Psychiatry and Psychotherapy, Medical Faculty, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany. maximilian.pilhatsch@uniklinikum-dresden.de.
Tasha GlennChronoRecord Association Inc., Fullerton, CA, USA.
Natalie RasgonDepartment of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Palo Alto, CA, USA.
Martin AldaDepartment of Psychiatry, Dalhousie University, Halifax, NS, Canada.
Kemal SagduyuDepartment of Psychiatry, University of Missouri Kansas City School of Medicine, Kansas City, MO, USA.
Paul GrofMood Disorders Center of Ottawa, University of Toronto, Toronto, Canada.
Rodrigo MunozDepartment of Psychiatry, University of California San Diego, San Diego, CA, USA.
Wendy MarshDepartment of Psychiatry, University of Massachusetts, Worcester, MA, USA.
Scott MonteithMichigan State University College of Human Medicine, Traverse City Campus, Traverse City, MI, USA.
Emanuel SeverusDepartment of Psychiatry and Psychotherapy, Medical Faculty, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
Rita BauerDepartment of Psychiatry and Psychotherapy, Medical Faculty, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
Philipp RitterDepartment of Psychiatry and Psychotherapy, Medical Faculty, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
Peter C WhybrowDepartment of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA.
Michael BauerDepartment of Psychiatry and Psychotherapy, Medical Faculty, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPolypharmacy is often prescribed for bipolar disorder, yet medication non-adherence remains a serious problem. This study investigated the regularity in the daily dosage taken of mood stabilizers and second generation antipsychotics.

methodsDaily self-reported data on medications taken and mood were available from 241 patients with a diagnosis of bipolar disorder who received treatment as usual. Patients who took the same mood stabilizer or second generation antipsychotic for ≥ 100 days were included. Approximate entropy was used to determine serial regularity in daily dosage taken. Generalized estimating equations were used to estimate if demographic or clinical variables were associated with regularity.

resultsThere were 422 analysis periods available from the 241 patients. Patients took drugs on 84.4% of days. Considerable irregularity was found, mostly due to single-day omissions and dosage changes. Drug holidays (missing 3 or more consecutive days) were found in 35.8% of the analysis periods. Irregularity was associated with an increasing total number of psychotropic drugs taken (p = 0.009), the pill burden (p = 0.026), and the percent of days depressed (p = 0.049).

conclusionDespite low missing percent of days, daily drug dosage may be irregular primarily due to single day omissions and dosage changes. Drug holidays are common. Physicians should expect to see partial adherence in clinical practice, especially with complex drug regimens. Daily dosage irregularity may impact the continuity of drug action, contribute to individual variation in treatment response, and needs further study.

Indexed as

AdherenceBipolar disorderMood stabilizersPolypharmacySecond generation antipsychotics

Identifiers

PMID29713845
PMCPMC6161976

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.