Antipsychotic Treatment Experiences of People with Bipolar I Disorder: Patient Perspectives from an Online Survey

Authors

Martha Sajatovic, Case Western Reserve UniversityFollow

Author ORCID Identifier

Martha Sajatovic

Document Type

Article

Publication Date

7-10-2020

Abstract

Background: Oral antipsychotic (AP) medications are frequently prescribed to people with bipolar I disorder (BD-I). A cross-sectional online survey examined the experiences of people living with BD-I with a history of recent AP use. Methods: Adults with self-reported physician-diagnosed BD-I (N = 200) who received oral APs during the prior year completed a survey on AP-related experiences, including side effects and their perceived burden on social functioning, adherence, and work. Items also assessed preferences for trade-offs (balancing symptom management and side effects) when considering a hypothetical new AP. The perceived impact of specific, prevalent side effects on adherence, work, and preferences for a hypothetical AP were also examined. Analyses were descriptive. Results: The survey sample had a mean age of 43.2 (SD = 12.4) years, was 60% female, and 31% nonwhite. Almost all participants (98%) had experienced AP side effects. Common self-reported side effects were feeling drowsy or tired (83%), lack of emotion (79%), anxiety (79%), dry mouth (76%), and weight gain (76%). Weight gain was cited as the most bothersome side effect, rated by most participants (68%) as "very"or "extremely bothersome."Nearly half of participants (49%) reported that AP side effects negatively impacted their job performance; almost all (92%) reported that side effects-most commonly anxiety and lack of emotion-negatively impacted social relationships (e.g., family or romantic partners). The most commonly-reported reason for stopping AP use was dislike of side effects (48%). Side effects most likely to lead to stopping or taking less of AP treatment included "feeling like a 'zombie'"(29%), feeling drowsy or tired (25%), and weight gain (24%). When considering a hypothetical new AP, the most common side effects participants wanted to avoid included AP-induced anxiety (50%), weight gain (48%), and "feeling like a 'zombie'"(47%). Conclusions: Side effects of APs were both common and bothersome, and impacted social functioning, adherence, and work. Findings highlight the prevailing unmet need for new APs with more favorable benefit-risk profiles.

Keywords

bipolar I disorder, bipolar disorder, antipsychotic, side effects, adherence, preference

Language

english

Publication Title

BMC Psychiatry

Rights

© The Author(s) 2020. This is an Open Access work distributed under the terms of the Creative Commons Attribution Licence (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Recommended Citation

Bessonova L, Velligan DI, Weiden PJ, O'Sullivan AK, Yarlas A, Bayliss M, Baranwal N, Rychlec K, Carpenter-Conlin J, Doane MJ, Sajatovic M. Antipsychotic treatment experiences of people with bipolar I disorder: patient perspectives from an online survey. BMC Psychiatry. 2020 Jul 6;20(1):354. doi: 10.1186/s12888-020-02767-x. PMID: 32631362; PMCID: PMC7371473.