Ohio antidepressant study finds many children nonadherent

Only one-fifth of children in Ohio who are prescribed antidepressants complete the recommended mimimum 6-month course of drugs to treat depression, reported a new study.

Researchers at Ohio State University in Columbus, Ohio, studied data from 1,650 Medicaid-covered children and adolescents in Ohio who were diagnosed with new episodes of depression between 2005 and 2007. They found that 49.5% adhered to the treatment during the acute phase, the first 3 months. About half the children stopped taking medication within 1 month of starting treatment. In addition, 41.6% of patients who maintained treatment for the first 3 months also adhered to treatment during the continuation phase of 3 additional months.

Only 20.6% of the patients studied completed a full 6 months of antidepressant treatment. “Nonadherence is common. With only half these kids adherent during the first 3 months and only a fifth adherent for the full 6 months of treatment, most of these kids are not even meeting the minimum standards of care,” said Cynthia Fontanella, an assistant professor of social work and psychiatry at OSU and lead author of the study.

Researchers attributed the higher rates of adherence during the first 3 months to better follow-up care and proper dosing of antidepressants. “More than 58% of kids who had at least 3 contacts with a mental-healthcare practitioner kept taking their drugs, compared to about one-third of children who had fewer contacts,” the authors wrote. Similarly, more than half the children taking an “adequate dose” of their antidepressant medication adhered to treatment, compared to 37.1% who received an inadequate dose.

The study also showed that non-Hispanic whites were more adherent than minority youths and that children 5 to 12 years old were more adherent than adolescents.