Real-World Evaluation of Treatment Response and Adherence in Bipolar Disorder: A Cross-Sectional Study from a Semi-Urban South Indian Tertiary Care Hospital

Background Bipolar disorder (BD) is a chronic psychiatric condition characterized by recurrent episodes of mania and depression, significantly impairing quality of life. Although pharmacological treatment remains central to management, data on prescribing patterns and clinical outcomes from Indian tertiary care centers are limited. Methods This cross-sectional observational study included one hundred patients diagnosed with BD according to the International Classification of Diseases (ICD) criteria. Symptom severity was evaluated using the Young Mania Rating Scale (YMRS) for mania and the Hamilton Depression Rating Scale (HAM-D) for depressive symptoms. Patients received individualized treatment regimens, including mood stabilizers, antipsychotics, and benzodiazepines. Pre- and post-treatment symptom scores were compared using paired t-tests. Medication adherence was evaluated using the chi-square test, with p  < 0.05 considered statistically significant. Results The majority of patients were female (65%), aged 29–38 years (38%), and from semi-urban areas (68%). A family history of psychiatric illness was present in 70%, and 51% reported suicidal ideation. Post-treatment, YMRS and HAM-D scores showed significant reductions (mean difference: 5.14 and 3.15, respectively; p  < 0.0001), with higher treatment responsiveness observed in mild and moderate severity groups. Diazepam, trihexyphenidyl, haloperidol, lithium, and sodium valproate were the most commonly prescribed agents. Medication adherence improved significantly post-treatment ( p  < 0.001), particularly among patients with mild symptoms. Conclusion Standard pharmacological therapy effectively reduced manic and depressive symptoms in bipolar disorder. Improved adherence was linked to better clinical outcomes. Taken together, these findings underscore the importance of early diagnosis, individualized treatment, and comprehensive psychosocial support in optimizing BD management in tertiary care settings.