Determinants of antidepressant treatment compliance: Implications for policy

Depression is among the most prevalent, devastating, and undertreated disor ders in our society. Treatment with antidepressant medications is effective in controlling symptoms, but treatment beyond the point of symptom resolut ion is necessary to restore functional status and prevent recurrent episode s. An important step in improving compliance is to identify the determinant s of antidepressant treatment compliance. A broader motivation for our stud y is to examine compliance by patients with a chronic but treatable disease . With claims data between 1990 and 1993, this study uses logistic regressi on analysis to examine the determinants of compliance among 2,012 antidepre ssant recipients. The results show that initiating treatment with a tricycl ic antidepressant reduces the probability of antidepressant treat ment comp liance. Initiating treatment with a selective serotonin reuptake inhibitor and undergoing family, group, or individual psychotherapy treatments increa se the probability of compliance. Case management does not meaningfully aff ect compliance. Implications for policy and clinical practice are discussed .