Medication Adherence and Compliance
Uncontrolled variables in psychiatric clinical drug trials
According to Griswold, Murray & Corrado (2012), one troubling aspect of psychotropic drug clinical trials is the lack of controls for subjects' adherence to medication protocols. Psychiatric patients in particular have historically been noted to have relatively low levels of compliance. In general, "as drug dosages increase, treatment adherence decrease" because of intensification of symptoms, difficulty remembering dosages, and other issues (Griswold, Murray & Corrado 2012). Under-medicating or discontinuing medications is common in schizophrenic and bipolar patients, due to reasons such as "perceived or real decreases in disease progression or symptomatology, perceived helplessness, defense mechanisms such as denial, motivational apathy, and lack of family or financial support"(Griswold, Murray & Corrado 2012). For potentially addictive substances such as stimulants and opioids, over-medication is a greater risk.
The study specifically took the form of a literature review. The authors conducted a search using clinical drug trials from PubMed / Medline, Science Direct, Scirus, and Scopus from 2002-2012. All trials used human subjects. Studies were examined to see if controls for subject adherence were conducted. In the seven categories of drug types of (1) antidepressants, (2)...
Participants were included if they had experienced sexual or physical assault in childhood or adulthood and met criteria for PTSD at the time of the initial assessment, were at least 3 months posttrauma (no upper limit), and if on medication, were stabilized. Women with current substance dependence were included if/when they had been abstinent for 6 months. Those with substance abuse were permitted to participate if they agreed to
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