CNS Drugs

, Volume 30, Issue 9, pp 819–835 | Cite as

Medication Adherence in Patients with Bipolar Disorder: A Comprehensive Review

  • Jennifer B. LevinEmail author
  • Anna Krivenko
  • Molly Howland
  • Rebecca Schlachet
  • Martha Sajatovic
Review Article


Poor medication adherence is a pervasive problem that causes disability and suffering as well as extensive financial costs among individuals with bipolar disorder (BD). Barriers to adherence are numerous and cross multiple levels, including factors related to bipolar pathology and those unique to an individual’s circumstances. External factors, including treatment setting, healthcare system, and broader health policies, can also affect medication adherence in people with BD. Fortunately, advances in research have suggested avenues for improving adherence. A comprehensive review of adherence-enhancement interventions for the years 2005–2015 is included. Specific bipolar adherence-enhancement approaches that target knowledge gaps, cognitive patterns, specific barriers, and motivation may be helpful, as may approaches that capitalize on technology or novel drug-delivery systems. However, much work remains to optimally facilitate long-term medication adherence in people with BD. For adherence-enhancement approaches to be widely adapted, they need to be easily accessible, affordable, and practical.


Bipolar Disorder Medication Adherence Prospective Memory Poor Adherence Brief Psychiatric Rate Scale 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Compliance with Ethical Standards


This work was supported in part by the Neurological and Behavioral Outcomes Center, University Hospitals Case Medical Center, Cleveland, Ohio, USA.

Conflict of interest

Jennifer Levin receives partial salary support from the following research grants: Reuter Foundation, Reinberger Foundation, Woodruff Foundation, Janssen Scientific Affairs, and National Institutes of Health (NIH). Martha Sajatovic receives partial salary support from the following research grants: Pfizer, Merck, and Ortho-McNeil Janssen, Janssen, Reuter Foundation, Woodruff Foundation, Reinberger Foundation, National Institute of Health (NIH), and Centers for Disease Control and Prevention (CDC). She has also been a consultant for Bracket, Prophase, Otsuka, Pfizer, Neurocrine, and Sunovion and has received royalties from Springer Press, Johns Hopkins University Press, Oxford Press, UpToDate, and Lexicomp. Ms. Krivenko, Ms. Howland, and Dr. Schlachet report no conflicts of interest.


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of PsychiatryCase Western Reserve University School of Medicine, University Hospitals Case Medical CenterClevelandUSA
  2. 2.Neurological and Behavioral Outcomes CenterUniversity Hospitals Case Medical CenterClevelandUSA
  3. 3.Department of NeurologyCase Western Reserve University School of Medicine, University Hospitals Case Medical CenterClevelandUSA
  4. 4.Department of PsychologyCleveland State UniversityClevelandUSA

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