Antidepressant Noncompliance as a Factor in the Discontinuation Syndrome

Compliance is generally defined as the extent to which a patient adheres to a treatment regimenand, specifically, takes medication as prescribed. While little research is available about the numberof patients who consistently skip antidepressant doses, the literature indicates that about 30% of patientsdiscontinue treatment suddenly within the first month. Both missed doses and abrupt stoppageof treatment place a patient at risk for experiencing discontinuation symptoms. A variety of reasonsranging from forgetfulness to lack of knowledge about the importance of taking every dose may leadto nonadherence to an antidepressant regimen. By spending time on patient education, providing reasonswhy patients should take every antidepressant dose, discussing alternative treatments, and conveyingempathy, support for, and understanding of the patient, physicians may be able to minimizenoncompliance and consequently decrease the likelihood that a patient may experience discontinuationsymptoms. Discontinuation of an antidepressant can cause a patient to be irritable, experiencesevere dizziness, or act emotionally absent, which may have a sustained adverse impact both on jobperformance and on family and social relationships.