Please use this identifier to cite or link to this item: https://doi.org/10.1097/01.pra.0000445246.46424.fe
Title: Adherence to antidepressant combinations and monotherapy for major depressive disorder: A CO-MED report of measurement-based care
Authors: Warden, D.
Trivedi, M.H.
Carmody, T.
Toups, M.
Zisook, S.
Lesser, I.
Myers, A.
Kurian, K.R.B.
Morris, D.
John Rush, A. 
Keywords: adherence
antidepressants
depression
discontinuation
implementation
medication combinations
persistence
Issue Date: 2014
Citation: Warden, D., Trivedi, M.H., Carmody, T., Toups, M., Zisook, S., Lesser, I., Myers, A., Kurian, K.R.B., Morris, D., John Rush, A. (2014). Adherence to antidepressant combinations and monotherapy for major depressive disorder: A CO-MED report of measurement-based care. Journal of Psychiatric Practice 20 (2) : 118-132. ScholarBank@NUS Repository. https://doi.org/10.1097/01.pra.0000445246.46424.fe
Abstract: Background. Non-adherence to antidepressant treatment is not routinely measured in practical clinical trials. It has not been related to outcomes in a large sample of adults with chronic and/or recurrent major depressive disorder (MDD) or any sample treated with antidepressant combinations. Methods. Adult outpatients with chronic and/or recurrent MDD were randomized to 12 weeks of treatment with bupropion-SR plus escitalopram, venlafaxine-XR plus mirtazapine, or escitalopram plus placebo. We compared non-adherence (the frequency with which daily medications were not taken) and specifically the frequency of temporarily stopping and/or skipping medication, or reducing or increasing the dose across treatments in 567 participants using a self-report questionnaire collected at each visit. We tested the association between non-adherence, and both treatment type and outcomes. Results. A non-adherence rate under 10% was reported by 77.9%, 70.9%, and 71.6% of participants during weeks 1-4, 5-12, and 1-12, respectively. Antidepressant combinations were associated with a higher non-adherence rate than monotherapy during weeks 1-4 and 1-12. During weeks 1-4, 24.1% stopped/skipped doses and 6.1% reduced the dose. During weeks 5-12, 34.7% stopped/skipped doses and 9.4% reduced the dose. Across 12 weeks, 43.2% stopped/skipped doses, and 12.9% reduced the dose. Stopping/skipping doses during all time frames and dose decreases during weeks 1-12 occurred most frequently with combination treatments. Non-adherence was unrelated to symptom remission, response, or symptom change. Conclusions. With closely monitored treatment, non-adherence is low and unrelated to depressive symptom outcome. Nonadherence is highest with antidepressant combinations. Specific non-adherent events are most often sporadic.
Source Title: Journal of Psychiatric Practice
URI: http://scholarbank.nus.edu.sg/handle/10635/109914
ISSN: 15274160
DOI: 10.1097/01.pra.0000445246.46424.fe
Appears in Collections:Staff Publications

Show full item record
Files in This Item:
There are no files associated with this item.

SCOPUSTM   
Citations

16
checked on Oct 16, 2019

WEB OF SCIENCETM
Citations

16
checked on Oct 16, 2019

Page view(s)

84
checked on Oct 11, 2019

Google ScholarTM

Check

Altmetric


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.