Aligning Bipolar Disorder Treatment Goals and Maintaining Patient Adherence

In the landscape of bipolar disorder treatment, a significant disparity can arise between the goals of patients and clinicians. Patients grapple with daily challenges and merely getting through the day, while clinicians understand the importance of addressing hypomania and mania and recognize that effective management can alleviate the long-term severity of the illness. At Psych Congress Elevate, Psych Congress Network met with Veronica Ridpath, DO, clinical associate professor at the University of South Carolina School of Medicine, and discussed how aligning patient understanding with medical objectives can pave the way for enhanced adherence and lead to more effective, empathetic, and holistic bipolar disorder treatment.

Catch up on what you missed at this year's Psych Congress Elevate in our conference newsroom, and register for next year in Las Vegas, Nevada, on the conference website.

Read the Transcript: 

Psych Congress Network: What are the primary challenges for clinicians working with patients with bipolar disorder? What about challenges for prescribing antipsychotics in general?

Veronica Ridpath, DO: The biggest problem with treating patients with bipolar disorder is that oftentimes our goals of treatment are not going to align as much. For patients, the things that are really important to them are going to be, ‘can I get through my day? Am I having these cognitive concerns? I can't think, I can't focus, I'm depressed, I don't want to do things.’ Hypomania may not be the thing that's on their radar, because if they're more productive, more energetic, feeling euphoric, that may not be a goal of treatment for them. Whereas for us as clinicians, we know that treating hypomania and mania appropriately is really going to help the natural course of that illness be less severe and less debilitating over time. The biggest challenge is really making sure that patients are aware of how our treatment goals are going to help match with their treatment goals over time, even if they don't necessarily seem to align in the moment.

PCN: What are the limitations of traditional antipsychotic agents and off-label therapies?

Dr Ridpath: The biggest challenge for treating patients with bipolar disorder, and particularly looking at the second generation antipsychotic therapy is patient adherence. The reasons for poor patient adherence are often side effect related, like weight gain, sedation, not really targeting the debilitating symptoms that are going to be more pressing in their day-to-day life. Anytime we're selecting therapy, something that a patient can take, reducing the number of times per day that they can take it, making sure that it's going to have realistic expectations as far as how long it's going to take to work and what we're looking for as far as treatment endpoints. Making sure that patients are on the same page can really help with understanding how they're going to do better with these medications.

Veronica Ridpath, DO, is a clinical associate professor at the University of South Carolina School of Medicine in the department of neuropsychiatry and behavioral science and serves as department chair for psychiatry and substance use at HopeHealth in Florence, South Carolina. Dr Ridpath graduated cum laude from University of North Carolina-Charlotte with a Bachelor of Science in psychology with minors in biology and classical studies. She obtained her Doctor of Osteopathic Medicine from Edward Via College of Osteopathic Medicine, where she was a National Health Service Corp scholar. Dr Ridpath has published and presented primarily in the areas of substance use, primary care and psychiatry integration, and medical student and resident education.