ABSTRACT
INTRODUCTION Antidepressants are the most commonly prescribed medicine accounting for about 120 million prescriptions per year, or 5% of all drugs prescribed in the United States, according to Centers for Disease Control and Prevention (1). In accordance with national recommendations, they are often prescribed for periods of 6 or 12 months. In clinical practice, they may be continued for decades. Only recently has it become clear that most people have great difficulty following an extended course and, as such, are often labeled “nonadherent” (2,3,14). However, this is an oversimplification of a complex problem that includes discontinuation, missed doses, excess doses, and in some cases, recommencement after prematurely stopping. As depression is increasingly thought of as a chronic illness, it is useful to compare medication habits with other long-term conditions (4). Barber and colleagues found that only 16% of patients taking medication for stroke, coronary heart disease, asthma, diabetes, and rheumatoid arthritis were adherent, problem free, and in receipt of sufficient information when examined at 10 days (5). The following chapter comprises a thorough literature review with regard to treatment noncompliance in major depressive disorder.
