Antidepressant Noncompliance as a Factor in the Discontinuation Syndrome

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Compliance is generally defined as the extent to which a patient adheres to a treatment regimen and, specifically, takes medication as prescribed. While little research is available about the number of patients who consistently skip antidepressant doses, the literature indicates that about 30% of patients discontinue treatment suddenly within the first month. Both missed doses and abrupt stoppage of treatment place a patient at risk for experiencing discontinuation symptoms. A variety of reasons ranging from forgetfulness to lack of knowledge about the importance of taking every dose may lead to nonadherence to an antidepressant regimen. By spending time on patient education, providing reasons why patients should take every antidepressant dose, discussing alternative treatments, and conveying empathy, support for, and understanding of the patient, physicians may be able to minimize noncompliance and consequently decrease the likelihood that a patient may experience discontinuation symptoms. Discontinuation of an antidepressant can cause a patient to be irritable, experience severe dizziness, or act emotionally absent, which may have a sustained adverse impact both on job performance and on family and social relationships.

J Clin Psychiatry 1997;58(suppl 7):31–36