Full Text Full Text (PDF) Full Text (Publish Ahead of Print[PDF]) Alert me when this article is cited Alert me if a correction is posted Citation Map Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Articles & Searches Download to citation manager Citing Articles via HighWire Citing Articles via Google Scholar Articles by Olfson, M. Articles by Wan, G. J. Search for Related Content PubMed Citation Articles by Olfson, M. Articles by Wan, G. J. Depression Antidepressants

Continuity of Antidepressant Treatment for Adults With Depression in the United States

OBJECTIVE: Continuation of antidepressant treatment for depression beyond the first months helps to consolidate treatment response and to reduce the risk of early relapse. The authors sought to characterize the rate and pattern of antidepressant discontinuation among adults initiating antidepressant treatment for depression. METHOD: Data were drawn from the household component of the Medical Expenditure Panel Survey for 1996–2001. Analysis was limited to data for adults age 18 years and older (N=829) who initiated antidepressant treatment for depression and who 1) discontinued treatment during the first 30 days of treatment, 2) completed the first 30 days of treatment and then discontinued treatment during the following 60 days, or 3) continued treatment for more than 90 days after treatment initiation. RESULTS: A majority of the patients discontinued antidepressant therapy during the first 30 days (42.4%). Only 27.6% of the patients continued antidepressant therapy for more than 90 days. Antidepressant discontinuation during the first 30 days of treatment was significantly more common among Hispanics (53.8%) than non-Hispanics (41.3%); patients with fewer than 12 years of education (50.8%), compared with those with 12 or more years (39.3%); and patients with low family incomes (50.2%), compared with those with medium or high family incomes (38.6%). Patients were significantly more likely to continue antidepressant treatment beyond 30 days if they received psychotherapy (68.0% versus 43.7%), completed 12 or more years of education (64.8% versus 52.0%), or had private health insurance (60.1% versus 50.8%). Among those who continued antidepressants beyond 30 days, antidepressant continuity during the subsequent 60 days was significantly associated with fair or poor pretreatment self-rated mental health and physical health, treatment with a selective serotonin reuptake inhibitor or serotonin-norepinephrine reuptake inhibitor, and psychotherapy. CONCLUSIONS: Early discontinuation of antidepressant therapy is widespread in the community treatment of depression, especially among socioeconomically disadvantaged patients. Provision of psychotherapy and selection of an appropriate antidepressant medication may reduce the risk of discontinuation during the first 3 months of antidepressant treatment for depression.

This article has been cited by other articles:

				E. C. van Geffen, M. Kruijtbosch, A. C. Egberts, E. R Heerdink, and R. van Hulten Patients' Perceptions of Information Received at the Start of Selective Serotonin-Reuptake Inhibitor Treatment: Implications for Community Pharmacy Ann. Pharmacother., April 1, 2009; 43(4): 642 - 649. [Abstract] [Full Text] [PDF]

				N. M. Lanouette, D. P. Folsom, A. Sciolla, and D. V. Jeste Psychotropic Medication Nonadherence Among United States Latinos: A Comprehensive Literature Review Psychiatr Serv, February 1, 2009; 60(2): 157 - 174. [Abstract] [Full Text] [PDF]

				M. Olfson, D. K. Cherry, and R. Lewis-Fernandez Racial Differences in Visit Duration of Outpatient Psychiatric Visits Arch Gen Psychiatry, February 1, 2009; 66(2): 214 - 221. [Abstract] [Full Text] [PDF]

				I. Lesser, S. Zisook, D. Flores, A. Sciolla, S. Wisniewski, I. Cook, M. Epstein, A. Rosales, C. Gonzalez, M. Trivedi, et al. Depression Outcomes of Spanish- and English-Speaking Hispanic Outpatients in STAR*D Psychiatr Serv, November 1, 2008; 59(11): 1273 - 1284. [Abstract] [Full Text] [PDF]

				K. Demyttenaere and L. Jaspers Review: Bupropion and SSRI-induced side effects J Psychopharmacol, September 1, 2008; 22(7): 792 - 804. [Abstract] [PDF]

				P. Rohde, S. G. Silva, S. T. Tonev, B. D. Kennard, B. Vitiello, C. J. Kratochvil, M. A. Reinecke, J. F. Curry, A. D. Simons, and J. S. March Achievement and Maintenance of Sustained Response During the Treatment for Adolescents With Depression Study Continuation and Maintenance Therapy Arch Gen Psychiatry, April 1, 2008; 65(4): 447 - 455. [Abstract] [Full Text] [PDF]

				A. Fujita, H. Azuma, T. Kitamura, K. Takahashi, T. Akechi, and T. A. Furukawa Adequacy of continuation and maintenance treatments for major depression in Japan J Psychopharmacol, March 1, 2008; 22(2): 153 - 156. [Abstract] [PDF]

				E. C. van Geffen, R. van Hulten, M. L Bouvy, A. C. Egberts, and E. R Heerdink Characteristics and Reasons Associated with Nonacceptance of Selective Serotonin-Reuptake Inhibitor Treatment Ann. Pharmacother., February 1, 2008; 42(2): 218 - 225. [Abstract] [Full Text] [PDF]

				Bibliography for Major Depressive Disorder and Suicide Focus, January 1, 2008; 6(1): 58 - 62. [Full Text] [PDF]

				M. Olfson, S. C. Marcus, and B. G. Druss Effects of Food and Drug Administration Warnings on Antidepressant Use in a National Sample Arch Gen Psychiatry, January 1, 2008; 65(1): 94 - 101. [Abstract] [Full Text] [PDF]

				A. Interian, I. E. Martinez, P. J. Guarnaccia, W. A. Vega, and J. I. Escobar A Qualitative Analysis of the Perception of Stigma Among Latinos Receiving Antidepressants Psychiatr Serv, December 1, 2007; 58(12): 1591 - 1594. [Abstract] [Full Text] [PDF]

				B. N. Gaynes, A. J. Rush, M. H. Trivedi, S. R. Wisniewski, G. K. Balasubramani, D. C. Spencer, T. Petersen, M. Klinkman, D. Warden, L. Nicholas, et al. Major Depression Symptoms in Primary Care and Psychiatric Care Settings: A Cross-Sectional Analysis Ann. Fam. Med, March 1, 2007; 5(2): 126 - 134. [Abstract] [Full Text] [PDF]

				S. Andersson Early discontinuation of antidepressant treatment in adults is very common in the USA. Evid. Based Ment. Health, August 1, 2006; 9(3): 65 - 65. [Full Text] [PDF]

				Antidepressants: Which Patients Adhere to Treatment? Which Don't? Journal Watch Psychiatry, April 5, 2006; 2006(405): 12 - 12. [Full Text]

				Antidepressants: Which Patients Adhere to Treatment? Which Don't? Journal Watch Women's Health, February 21, 2006; 2006(221): 5 - 5. [Full Text]

Get information about faster international access.

Privacy Policy

Copyright © 2006 American Psychiatric Association. All rights reserved.

Home | Search | Current Issue | Past Issues | Subscribe | All APPI Journals | Help | Contact Us