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

Published online by Cambridge University Press:  02 January 2018

Rajini Ramana ,
Eugene S. Paykel ,
Paul G. Surtees ,
David Melzer  and
Mitul A. Mehta
Rajini Ramana*
Affiliation:
Fulbourn Hospital, Fulboum, Cambridge
Eugene S. Paykel
Affiliation:
University of Cambridge, Addenbrooke's Hospital, Cambridge
Paul G. Surtees
Affiliation:
MRC Biostatistics Unit, Institute of Public Health, University of Cambridge, Forvie Site, Addenbrooke's Hospital, Cambridge
David Melzer
Affiliation:
Department of Community Medicine, Institute of Public Health, University of Cambridge
Mitul A. Mehta
Affiliation:
Department of Psychiatry, University of Cambridge
*
Rajini Ramana, Fulbourn Hospital. Fulbourn, Cambridge CB1 5EF
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Abstract

Background

The adequacy of pharmacotherapy received in practice by patients after an acute episode of depression has been little studied.

Aims

To describe and assess adequacy of drug continuation and maintenance in patients with depression.

Method

Patients with depression were interviewed 18 months after discharge from hospital. Quantitative assessments of drug treatment doses and compliance were made monthly over this period, and qualitative ratings in continuation and maintenance phases.

Results

About 20% of patients were prescribed low drug doses after discharge and 10% were prescribed no drugs at all. Reported compliance was around 70%. About 30% failed to receive adequate longer-term treatment, mostly due to the continuation phase being too short. Deficiencies of dosage and compliance were greater in patients who never achieved full recovery. Patient refusal was the most common reason for not using antidepressants. Further episodes of depression were not particularly associated with inadequate treatment.

Conclusions

There were deficiencies in drug treatment that did not appear to be the principal cause of further episodes but may be important in non-recovery. Patient fears require discussion.

Type
Papers
Information
The British Journal of Psychiatry , Volume 174 , Issue 2 , February 1999 , pp. 128 - 134
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

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Footnotes

Declaration of interest Study supported by the East Anglian Regional Health Authority.

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