Patient Follow-up & Hospitalization

Supervision of treatment and routine follow-up by a clinician are needed for successful long-term therapy of bipolar disorder. The need for medical monitoring of drug blood levels will vary with the particular pharmacologic agent selected; however, continued supervision is needed to ensure treatment adherence regardless of the particular agent. Routine follow-up visits are used to evaluate the individual’s condition and provide an opportunity to adjust medication as needed.

In general, although nonpharmacologic strategies provide a number of benefits, the efficacy of these approaches can be limited unless the person is willing to adhere to the treatment plan.

When Hospitalization should be considered for patients with bipolar disorder?

Many people with bipolar I disorder are hospitalized at some point during the course of the illness. Affected individuals are often unwilling to enter the hospital voluntarily and may need to be hospitalized to prevent dangerous behavior or consequences to others. For example, those with mania often have a lack of insight into their disorder and do not understand the need for hospitalization.

Hospitalization should be considered under the following circumstances:

• when safety is a question due to suicidal, homicidal, or aggressive impulses or actions
• when severe distress or dysfunction requires around-the-clock care and support
• when there is ongoing substance abuse, to prevent access to drugs
• when the person has an unstable medical condition
• when close observation of the person’s reaction to medications is required.