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Improving Antidepressant Adherence

Charles B. Nemeroff, MD, PhD

Published: December 1, 2003

Article Abstract

Frequently, patients suffering from depressive disorders discontinue antidepressant treatment dueto the unpleasant side effects of these medications, particularly in the first month of therapy. Goodtolerability (particularly in the early stages of treatment), patient education, and the quality of the relationshipbetween physicians and patients are all common determining factors of patient adherence.Controlled-release antidepressant agents have the potential to improve tolerability early in the courseof therapy, one of the most likely periods of dropout from treatment. Side effects for controlled-releaseformulations are often more favorable because controlled-release formulations exhibit lowerpeak plasma drug concentrations when compared with immediate-release formulations. Venlafaxineextended-release (XR), bupropion sustained-release (SR), and paroxetine controlled-release (CR) are3 commonly utilized controlled-release antidepressants that have demonstrated improvement overtheir immediate-release predecessors in reducing certain adverse effects.

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