title: No difference in adherence to paroxetine between depressed patients with early remission and those with late remission based on monitoring of plasma paroxetine concentrations.
abstract: Selective serotonin reuptake inhibitors (SSRIs) are widely used to treat both anxiety disorders and depressive disorders. However, nonadherence to SSRIs is a major issue in recurrence. In the present study, we investigated paroxetine adherence in depressed patients by monitoring the plasma paroxetine concentrations between patients with rapid and those with a late response to paroxetine treatment. Twenty inpatients in our university hospital, who met the DSM-IV-TR diagnosis of major depressive disorder in a single episode, were enrolled in the study. Twelve patients (M/F: 7/13, age: 37.4 +/- 10.4 years) were treated with paroxetine (40 mg/day), and all achieved remission (HAMD < or = 7) within at least 12 weeks. We divided the patients into two groups, an early-remission group (HAMD < or = 7 within 4 weeks) and a late-remission group (HAMD < or = 7 within 8-12 weeks). Their dosages of paroxetine were constant because of no emerging adverse effects. Blood samples were obtained on the day the subjects were discharged (B) and 12 weeks after discharge. The paroxetine concentrations in the early-remission group were significantly decreased 12 weeks after discharge, and no difference was found between the early- and late-remission groups. These results suggest that adherence to paroxetine was independent of the duration of the depressive state suffered by the patients. Clinicians always take their cautions for the adherence to paroxetine regardless of the clinical time courses the patients recovering from their depressive symptoms.
authors: Department of Psychiatry, University of Occupational and Environmental Health, Yahatanishi-ku, Kitakyushu, Japan. yoshi621@med.uoeh-u.ac.jp
authors: Reiji
authors: R
authors: Yoshimura
authors: Wakako
authors: W
authors: Umene-Nakano
authors: Nobuhisa
authors: N
authors: Ueda
authors: Atsuko
authors: A
authors: Ikenouchi-Sugita
authors: Hikaru
authors: H
authors: Hori
authors: Asuka
authors: A
authors: Katsuki
authors: Kenji
authors: K
authors: Hayashi
authors: Kyoko
authors: K
authors: Miyamoto
authors: Yuki
authors: Y
authors: Kodama
authors: Jun
authors: J
authors: Nakamura
mesh_terms: D000328:Adult; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000503:physiopathology; D004305:Dose-Response Relationship, Drug; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007297:Inpatients; D008297:Male; D055118:Medication Adherence; D017374:Paroxetine / Q000097:blood* / Q000627:therapeutic use*; D017367:Selective Serotonin Reuptake Inhibitors / Q000097:blood* / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D017374:Paroxetine; D017367:Selective Serotonin Reuptake Inhibitors