Adherence to continuation and maintenance antidepressant use in recurrent depression

Background: In chronic diseases adherence is a problem. Little is known about adherence to antidepressants after the acute phase in recurrent depression. This study evaluates adherence to antidepressants in the continuation and maintenance phase in remitted recurrently depressed patients.

Methods: We prospectively assessed adherence to continuation and maintenance antidepressant use, the longest phase in antidepressant treatment, over 2 years and the association of adherence with future recurrence in 131 recurrently depressed patients remitted on antidepressants.

Limitations: Self reported non-adherence.

Results: Non-adherence ranged from 39.7% to 52.7%; 20.9% were always non-adherent, 48.4% were intermittently non-adherent and 30.8% were always adherent. Adherence rates did not significantly differ between intermittent and continuous antidepressant users (37.2% vs. 25%). Non-adherence predicted time to recurrence.

Conclusion: Non-adherence to continuation and maintenance antidepressant treatment in recurrent depression is frequent, like in other chronic diseases, and a potential risk of recurrence. Doctors continuously have to be aware of this problem and should keep on discussing it with their patients. Finally, as many patients don't seem to be able or willing to take AD as prescribed, alternatives to prevent relapse deserve more attention. (C) 2008 Elsevier B.V. All rights reserved.