Medication received by patients with depression following the acute episode: adequacy and relation to outcome

Background The adequacy of pharmacotherapy received in practice by patients after an acute episode of depression has been little studied. Aims To desc ribe and assess adequacy of drug continuation and maintenance in patients w ith depression. Method Patients with depression were interviewed 18 months after discharge from hospital. Quantitative assessments of drug treatment doses and complia nce were made monthly over this period, and qualitative ratings in continua tion and maintenance phases. Results About 20% of patients were prescribed low drug doses after discharg e and 10% were prescribed no drugs at all. Reported compliance was around 7 0%. About 30% failed to receive adequate longer-term treatment, mostly due to the continuation phase being too short. Deficiencies of dosage and compl iance were greater in patients who never achieved full recovery. Patient re fusal was the most common reason for not using antidepressants. Further epi sodes of depression were not particularly associated with inadequate treatm ent. Conclusions There were deficiencies in drug treatment that did not appear t o be the principal cause of further episodes but may be important in non-re covery. Patient fears require discussion. Declaration of interest Study supported by the East Anglian Regional Health Authority.