Antipsychotic treatment experiences of people with bipolar i disorder: Patient perspectives from an online survey

Leona Bessonova, Dawn I. Velligan, Peter J. Weiden, Amy K. O'Sullivan, Aaron Yarlas, Martha Bayliss, Nishtha Baranwal, Kaitlin Rychlec, Julia Carpenter-Conlin, Michael J. Doane, Martha Sajatovic

Research output: Contribution to journalReview articlepeer-review

18 Scopus citations


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.

Original languageEnglish (US)
Article number354
JournalBMC Psychiatry
Issue number1
StatePublished - Jul 6 2020


  • Adherence
  • Antipsychotic
  • Bipolar I disorder
  • Bipolar disorder
  • Preference
  • Side effects

ASJC Scopus subject areas

  • Psychiatry and Mental health


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