University Department of Psychiatry, Royal South Hants Hospital, Graham Road, Southampton, UK.
J Psychopharmacol. 1994 Jan;8(1):48-52. doi: 10.1177/026988119400800108.
It has been known for some time that the compliance with antidepressants in general practice is sub-optimal, but no new studies have been carried out since the 1970s, since which time training in general practice has improved and new classes of antidepressants have been introduced. In this study 46 patients commenced on an antidepressant for clinical reasons by their GP were interviewed 10-12 weeks later by a research worker. Thirty two percent of patients stopped medication within 6 weeks and 63% of these did not inform their GP of their decision. Side-effect burden was significantly associated with non-compliance. Selective serotonin re-uptake inhibitors showed a slight but non-significant compliance advantage in this small study but all patients treated with SSRIs were initially prescribed a dose for which there is evidence of superiority of effect over placebo, while only 30% of those on tricyclics were prescribed such a dose. Further work to establish accurate methods of determining compliance and effective ways of enhancing compliance with antidepressants in general practice is required.
一段时间以来，人们已经知道，一般实践中抗抑郁药的依从性并不理想，但自 20 世纪 70 年代以来，没有进行新的研究，因为自那时以来，一般实践培训已经得到改善，并且已经引入了新的抗抑郁药类别。在这项研究中，46 名因临床原因由全科医生开始服用抗抑郁药的患者在 10-12 周后由研究人员进行了采访。32%的患者在 6 周内停止服药，其中 63%的患者没有将其决定告知其全科医生。副作用负担与不依从显著相关。在这项小型研究中，选择性 5-羟色胺再摄取抑制剂（SSRIs）显示出轻微但无统计学意义的依从性优势，但所有接受 SSRIs 治疗的患者最初都开了一种有证据表明其效果优于安慰剂的剂量，而只有 30%的三环类抗抑郁药患者开了这样的剂量。需要进一步开展工作，以建立确定依从性的准确方法，并找到有效增强一般实践中抗抑郁药依从性的方法。
