Improving Antidepressant Adherence

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Frequently, patients suffering from depressive disorders discontinue antidepressant treatment due to the unpleasant side effects of these medications, particularly in the first month of therapy. Good tolerability (particularly in the early stages of treatment), patient education, and the quality of the relationship between physicians and patients are all common determining factors of patient adherence. Controlled-release antidepressant agents have the potential to improve tolerability early in the course of therapy, one of the most likely periods of dropout from treatment. Side effects for controlled-release formulations are often more favorable because controlled-release formulations exhibit lower peak plasma drug concentrations when compared with immediate-release formulations. Venlafaxine extended-release (XR), bupropion sustained-release (SR), and paroxetine controlled-release (CR) are 3 commonly utilized controlled-release antidepressants that have demonstrated improvement over their immediate-release predecessors in reducing certain adverse effects.

J Clin Psychiatry 2003;64(suppl 18):25-30