Navigating Medication Side Effects in Bipolar Disorder Treatment

Medication side effects can come with treatment in any field, but in psychiatry, managing patients' emotional and mental stability on top of side effects can be a challenge. However, when these side effects are effectively managed, according to Julie Carbray, PhD, PMHNP-BC, Psych Congress Network Bipolar Disorder Section Editor, it can be a "game-changer" for bipolar disorder treatment. 

While at the NP Institute in Boston, Massachusetts, in early 2023, Psych Congress Network sat down with Desiree Matthews, PHMNP-BC, the director of advanced practice providers at Monarch in Charlotte, North Carolina, to get her insights on side effects in bipolar disorder treatment and how she works with patients to avoid the dealbreakers. 

Save the date for NP Institute In-Person, March 20-23, 2024, in San Diego, California! For more information, visit the meeting website.

Read the Transcript: 

Psych Congress Network: We know that weight gain side effects can be a dealbreaker for many patients taking psychiatric medication. What are some other reasons patients with bipolar disorder might stop taking their medication?

Desiree Matthews, PHMNP-BC: In addition to weight gain, side effects such as sexual side effects can be a big reason for patients to stop medication, but they probably won't volunteer that information. So it's really important to clinicians to ask these questions, because otherwise we won't know what to avoid in the future. Sedations, somnolence, and cognitive slowing motor impairment, these are also big reasons to stop medications. Especially if the sedation, somnolence, and these cognitive and motor impairments are interfering with the ability to get up and go to work, to drive, to take care of their kids. This is all something to consider.

When I'm talking to my patients and I'm interviewing them, I'm getting to know them. I really recommend clinicians explore reasons for maybe why they discontinued medications in the past. I ask them 'if there's 1 to 2 things that I could avoid with your medication, what would that be?' Oftentimes, sedation in the daytime and weight gain are the top 2. So if I know what the patients don't want out of their medications, I can tailor their treatment plan and consider agents that may be more favorable for their liking, their preference.

Desiree Matthews, PHMNP-BC, is a board-certified Psychiatric Mental Health Nurse Practitioner. She received her Bachelor's of Nursing from University at Buffalo and her Master's of Nursing at Stony Brook University. She currently resides in Charlotte, NC, and practices at Monarch, a community mental health center providing telepsychiatry services to adult patients. Clinical interests include the treatment of schizophrenia, bipolar disorder, treatment-resistant unipolar depression, and drug-induced movement disorders, including tardive dyskinesia. She has provided faculty expertise and insight into the development of a clinical screener for TD called MIND-TD.