ABSTRACT
Drug non adherence is one of the major problems in treatment of psychiatric patients which could increase the risk of relapse and re-hospitalization. The aim of this study is to determine factors associated with drug non adherence by patients with mood disorders after their discharge from hospital and assessment of relation between drug attitude and drug adherence. In this cohort, prospective, and descriptive study, 150 patients with mood disorders [major depressive disorder, bipolar mood disorder] at the time of discharge were assessed. For each patient, demographic information form and Drug Attitude Inventory [DAI-10] [persian translation] was completed at the time of discharge. Then all of the patients were monitored monthly until 6 months through telephone. In every follow up DAI-10 and drug use inventory [which consists of causes of drug non adherence] were completed. Finally relation between different variables and patient drug attitude with drug adherence were assessed. From all studied variables such as demographic factors, diagnosis, treatment factors, and drug attitude, only drug attitude had a significant relation with drug adherence. Patients' attitude toward drugs has a major role in drug adherence
ABSTRACT
The effectiveness of various atypical antipsychotics in the treatment of acute mania is reported repeatedly, but those for typical antipsychotics are restricted to haloperidol and chlorpromazine. As there is a comparative importance of side effects for typical and atypical antipsychotics, we decided to compare the therapeutic effect of thiothixene and risperidone as a combination with lithium for the treatment of patients with bipolar disorder. In 8 week double-blind clinical trial, 84 patients with a diagnosis of bipolar disorder were randomized for treatment with lithium plus thiothixene [N=42] or lithium plus risperidone [N=42]. Manic, positive-negative symptoms, anxiety and depression were measured bi-weekly with Young Mania Rating, positive and negative symptom scale [PANSS] and Hamilton rating scale score. Fasting blood sugar, weight, general side effects and extrapyramidal symptoms were also evaluated. The measures analyzed using SPSS-17 software. To compare demographic characteristics t-test, chi[2] test and fixed effects method were used. A fixed effects method was applied to omit missing data effects. There was no significant difference between the thiothixene and risperidone groups in Young mania rating scale and other outcome measures during the 8 week trial. There was no significant difference in weight, blood sugar and clinical global impression [CGI] between groups. Thiothixene is as effective as risperidone in the improvement of manic and psychotic symptoms. There was no significant difference with risperidone in developing extrapyramidal symptoms, so it can be used as an appropriate combination with lithium for the treatment of bipolar patients in psychotic manic episode