Adherence to Antidepressant Treatment

It is estimated that10% of patients who are prescribed antidepressants never fill the prescription, 16% stop in the first week, 41% within 2 weeks, 59% in 3 weeks, and 68% in 4 weeks. The following instructions to patients may increase adherence:

  • Stress that the decision to begin antidepressants is not a sign of moral weakness. Although depression is still considered by some in this country to be a sign of moral weakness, the patient need not be one of them. Antidepressants have helped millions of people “get a leg up” on tackling their depression.
  • Explain to patients that antidepressant response can manifest within one or two weeks of beginning the medication with a noticeable increase in energy and motivation. Mood symptoms, assuming the antidepressant is working, improve anywhere from 4-8 weeks, so staying with the medication is imperative.
  • The patient should be aware that discernible side effects often diminish over time. Side effects are a part of the body’s adjustment to the introduction of something new to the system. Many of them pass within 2-4 days.
  • These medications are not habit forming. Although they should not be discontinued abruptly, antidepressants are not considered drugs of abuse potential.
  • Patients should be instructed that if their first antidepressant try is unsuccessful, others may be tried. Unfortunately, this remains a trial-and- error process whereby no-one-size-fits-all.
  • It is important for patients to realize the importance of “taking enough for long enough.” It is not uncommon for antidepressant users to think they’re cured when they start to feel sufficiently better. This is a recipe for remission and relapse.
  • Abruptly stopping an antidepressant can ignite an uncomfortable discontinuation syndrome. Patients should slowly taper off of these drugs if dosage reduction or complete stoppage is warranted.
Joseph Wegmann, R.Ph., LCSW is a licensed clinical pharmacist and a clinical social worker with more than thirty years of experience in the field of psychopharmacology. His diverse professional background in psychopharmacology and counseling affords him a unique perspective on medication management issues. In addition to consulting with numerous psychiatric facilities, he has presented psychopharmacology seminars to thousands of clinicians in 46 states.

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