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Titolo:
Adherence to treatment regimen in depressed patients treated with amitriptyline or fluoxetine
Autore:
Demyttenaere, K; Mesters, P; Boulanger, B; Dewe, W; Delsemme, MH; Gregoire, J; Van Ganse, E;
Indirizzi:
Univ Hosp Gasthuisberg, Dept Psychiat, B-3000 Louvain, Belgium Univ Hosp Gasthuisberg Louvain Belgium B-3000 t, B-3000 Louvain, Belgium Eli Lilly Belgium, Brussels, Belgium Eli Lilly Belgium Brussels BelgiumEli Lilly Belgium, Brussels, Belgium Lilly Res Labs, Brussels, Belgium Lilly Res Labs Brussels BelgiumLilly Res Labs, Brussels, Belgium Univ Catholique Louvain, Fac Psychol, Louvain, Belgium Univ Catholique Louvain Louvain Belgium , Fac Psychol, Louvain, Belgium Univ Lyon, Fac Pharmacol Clin, EVG, Lyon, France Univ Lyon Lyon FranceUniv Lyon, Fac Pharmacol Clin, EVG, Lyon, France
Titolo Testata:
JOURNAL OF AFFECTIVE DISORDERS
fascicolo: 3, volume: 65, anno: 2001,
pagine: 243 - 252
SICI:
0165-0327(200108)65:3<243:ATTRID>2.0.ZU;2-M
Fonte:
ISI
Lingua:
ENG
Soggetto:
ANTIDEPRESSANTS; WITHDRAWAL; THERAPY; CARE;
Keywords:
depressed patients; amitriptyline; fluoxetine;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Social & Behavioral Sciences
Life Sciences
Citazioni:
26
Recensione:
Indirizzi per estratti:
Indirizzo: Demyttenaere, K Univ Hosp Gasthuisberg, Dept Psychiat, Herestr 49, B-3000 Louvain, Belgium Univ Hosp Gasthuisberg Herestr 49 Louvain Belgium B-3000
Citazione:
K. Demyttenaere et al., "Adherence to treatment regimen in depressed patients treated with amitriptyline or fluoxetine", J AFFECT D, 65(3), 2001, pp. 243-252

Abstract

Objective: Non-compliance presents a constant challenge to effective therapy, Many studies only investigate early treatment discontinuation and not other measures like adherence to treatment regimen. We compared adherence indepressed patients using either a selective serotonin reuptake inhibitor (fluoxetine) or a tricyclic antidepressant (amitriptyline), and examined itsclinical relevance through adverse events, drop-out rates, and outcome. Adherence was measured electronically with the MEMS (Medication Event Monitoring System). Design: Nine-week double blind, randomized controlled trial. Setting: Ambulatory psychiatric care. Patients: Random sample of 66 depressed (DSM-RI-R criteria) patients. Intervention: Fluoxetine 20 mg or amitriptyline 150 mg. Main outcome measures: Time course of adherence and its relation to severe adverse events, drop-outs and outcome. Results: Non-adherence to the treatment regimen occurred frequently in both treatment groups: 31% of patients had at least one 3-day drug holiday, and 34% of patients had atleast one episode of three pills in a 24-h period. Over-consumption occurred more frequently during the -early phases of treatment while underconsumption occurred more frequently during the later phases. Patients on amitriptyline (P = 0.03) and patients with a higher pill intake (P = 0.01) experienced more severe adverse events. Patients on amitriptyline (P = 0.009) and patients with a lower adherence to the treatment regimen (P = 0.004) discontinued from treatment more frequently. The final Hamilton score was significantly predicted by a longer duration of treatment and by a better adherence, but only in amitriptyline. users. Conclusions: Non-adherence to the treatment regimen has important clinical consequences. Pharmacodynamics. and human behavior predict risk for severe adverse events and drop-outs. Moreover,in amitriptyline users but not in fluoxetine users, better adherence predicts a better outcome. (C) 2001 Elsevier Science BY All rights reserved.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/01/20 alle ore 19:00:50