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  • Bipolar disorder is a life-long illness that requires adherence to medications to prevent repeated episodes.

  • Polypharmacy is the rule in the treatment of bipolar disorder rather than the exception.

  • Adverse effects, drug interactions, and cost of medications can lead to nonadherence. MTM providers should be watchful of nonadherence and work with the patient to create a regimen that is both tolerable and affordable.

  • Inclusion of the patient in a therapeutic alliance can increase adherence to treatment and medications.


Bipolar disorder (previously known as manic-depressive disorder) is a cyclic mood disorder characterized by recurrent fluctuations in mood, energy, and behavior.1, 2, and 33 Bipolar disorder is a lifelong illness with a variable course and requires both nonpharmacological as well as pharmacological treatment.1, and 2 Episodes with bipolar disorder include not only major depression, but also hypomania, mania, and mixed episodes (Table 15-1).

Table 15-1.Evaluation and Diagnosis of Mood Episodes1

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