Non-compliance with pharmacotherapy of depression is associated with a sensation seeking personality

Inadequate compliance of drug intake is an important cause of ineffective p harmacotherapy and has been associated with therapeutic failure. We hypothe sized that sensation seeking personality traits would affect compliance wit h long-term antidepressant medication. Three hundred and eight depressed pa tients participating in a randomized double-blind study of sertraline and c italopram were included. Personality traits were assessed using the Karolin ska Scales of Personality. Compliance to medication was determined in two w ays, by means of tablet counting and by measurement concentration of drug i n serum. Tablet non-compliance was defined as less than 80% or more than 10 0% intake of the prescribed drug during weeks 20-24. Serum drug non-complia nce was defined as undetectable amounts of either drug and main metabolite in the serum samples at week 24. Two virtually mot overlapping groups of no n-compliant patients were identified, where those regarded as non-compliant due to the interpretation of the serum drug levels were in majority. The g roup of serum drug non-compliant patients were recognized by significantly higher scores on the Monotony Avoidance scale and the Impulsive Sensation S eeking Psychopathy factor. The need for better methods than tablet counting and patient questioning to ascertain compliance is emphasized. (C) 2000 Li ppincott Williams & Wilkins.