Selective Serotonin Reuptake Inhibitor Discontinuation

Goethe, John W.; Woolley, Stephen B.; Cardoni, Alex A.; Woznicki, Brenda A; Piez, Deborah A

doi:10.1097/jcp.0b013e31815152a5

Cited by 92 publications

(25 citation statements)

References 29 publications

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“…Similar to this study finding, studies from Canada reported better compliance to treatment among men [24]. However, findings contrary to this study have been reported from USA and Belgium where men were more likely to discontinue treatment without physician consent [25, 26]. This divergence in reported findings may be due to socio-cultural differences.…”

Section: Discussionsupporting

confidence: 59%

Factors Affecting Non-Adherence among Patients Diagnosed with Unipolar Depression in a Psychiatric Department of a Tertiary Hospital in Kolkata, India

Sohini

Varma

2013

Depression Research and Treatment

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Non-adherence to depression treatment is a common clinical problem globally. However, limited research is available from India. This cross-sectional study aimed to assess non-adherence to prescribed treatment among patients with unipolar depression at a psychiatric out-patient department (OPD) of a tertiary hospital in Kolkata, India. The Morisky Medication Adherence Scale (MMAS) was used and a questionnaire designed by the Principal Investigator (PI) was administered. A total of 239 patients with unipolar depression were interviewed of whom 66.9% (160) were non-adherent and 33.1% (79) were adherent to treatment. The difference was significant (Fisher's Exact <0.000). Women were nearly three times at a higher risk of being non-adherent compared to men (OR 2.7; 95% CI 1.0–7.1). The non-adherent group compared to the adherent group was significantly more likely to consume extra medicines than the recommended amount (OR 2.8; 95% CI 1.1–7.3) and had lower internal locus of control (LOC) (OR 4.5; 95% CI 2.4–8.3). Adherence to prescribed treatment in an out-patient clinical setting was a problem among patients with unipolar depression. Suitable interventions on individuals with the above mentioned attributes are required in India and in similar settings where non-adherence to depression therapy is an important public health problem.

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Section: Discussionsupporting

confidence: 59%

Factors Affecting Non-Adherence among Patients Diagnosed with Unipolar Depression in a Psychiatric Department of a Tertiary Hospital in Kolkata, India

Sohini

Varma

2013

Depression Research and Treatment

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“…Goethe et al reported that the discontinuation rate was 26.9%, and discontinuation rate did not differ among SSRIs 16. Total discontinuation rate in PD and MDD in the present study was 22.8%, which is concordant with the previous report 15,16…”

Section: Discussionsupporting

confidence: 92%

Factors affecting discontinuation of initial treatment with paroxetine in panic disorder and major depressive disorder

Aoki¹,

Ishiguro²,

Watanabe³

et al. 2014

NDT

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ObjectiveThe aims of the present study were to analyze the association between discontinuation of paroxetine (PAX) and the genetic variants of the polymorphism in the serotonin transporter gene-linked polymorphic region (5-HTTLPR) in Japanese patients with panic disorder (PD) and major depressive disorder (MDD).MethodsThe 5-HTTLPR genotype was determined by polymerase chain reaction method. PAX plasma concentration was measured by high-performance liquid chromatography to confirm adherence.ResultsWhen comparing between the PD and MDD patients with the chi-square test and Fisher’s exact test, the PD patients had a significant and higher discontinuation rate due to non-adherence than did the MDD patients (13.5% [7/52] versus 0% [0/88], respectively; P<0.001). MDD patients had a significant and higher discontinuation rate due to untraceability than PD patients (12.5% [11/88] versus 1.9% [1/52]; P=0.032). Multilogistic regression revealed a tendency for the long/short and short/short genotypes to affect discontinuation due to adverse effects in PD patients (25.0% versus 6.3%, respectively; P=0.054).ConclusionThe results indicate that the 5-HTTLPR genotype might contribute to the discontinuation of initial PAX treatment due to adverse effects in PD patients.

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“…Lack of adherence to psychotropic medicines remains a highly prevalent problem [ 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 ]. Among these, antidepressants show the greatest rates of non-adherence [ 63 ] Treatment adherence to antidepressants is essential in achieving remission, restoring previous levels of functioning and preventing reoccurrence of depression [ 64 , 65 , 66 , 67 ] and reduces health care utilization and costs [ 68 , 69 , 70 ].…”

Section: Quality Use Of Medicinesmentioning

confidence: 99%

New Roles for Pharmacists in Community Mental Health Care: A Narrative Review

Rubio-Valera

Chen

O’Reilly

2014

IJERPH

152

121

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Medicines are a major treatment modality for many mental illnesses, and with the growing burden of mental disorders worldwide pharmacists are ideally positioned to play a greater role in supporting people with a mental illness. This narrative review aims to describe the evidence for pharmacist-delivered services in mental health care and address the barriers and facilitators to increasing the uptake of pharmacist services as part of the broader mental health care team. This narrative review is divided into three main sections: (1) the role of the pharmacist in mental health care in multidisciplinary teams and in supporting early detection of mental illness; (2) the pharmacists’ role in supporting quality use of medicines in medication review, strategies to improve medication adherence and antipsychotic polypharmacy, and shared decision making; and (3) barriers and facilitators to the implementation of mental health pharmacy services with a focus on organizational culture and mental health stigma. In the first section, the review presents new roles for pharmacists within multidisciplinary teams, such as in case conferencing or collaborative drug therapy management; and new roles that would benefit from increased pharmacist involvement, such as the early detection of mental health conditions, development of care plans and follow up of people with mental health problems. The second section describes the impact of medication review services and other pharmacist-led interventions designed to reduce inappropriate use of psychotropic medicines and improve medication adherence. Other new potential roles discussed include the management of antipsychotic polypharmacy and involvement in patient-centered care. Finally, barriers related to pharmacists’ attitudes, stigma and skills in the care of patients with mental health problems and barriers affecting pharmacist-physician collaboration are described, along with strategies to reduce mental health stigma.

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Selective Serotonin Reuptake Inhibitor Discontinuation

Cited by 92 publications

References 29 publications

Factors Affecting Non-Adherence among Patients Diagnosed with Unipolar Depression in a Psychiatric Department of a Tertiary Hospital in Kolkata, India

Factors Affecting Non-Adherence among Patients Diagnosed with Unipolar Depression in a Psychiatric Department of a Tertiary Hospital in Kolkata, India

Factors affecting discontinuation of initial treatment with paroxetine in panic disorder and major depressive disorder

New Roles for Pharmacists in Community Mental Health Care: A Narrative Review

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