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Spontaneous lapses in dosing during chronic treatment with selective serotonin reuptake inhibitors
W E Meijer1, M L Bouvy, E R Heerdink
1Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht, The Netherlands. W.E.E.Meijer@pharm.uu.nl
Background:
In previous research, lapses in dosing of paroxetine or sertraline were associated with significantly more discontinuation symptoms and deterioration of depressive symptomatology compared with fluoxetine.
Aims:
To evaluate dosing lapses in patients chronically treated with selective serotonin reuptake inhibitors (SSRIs) in uncontrolled circumstances.
Method:
In a prospective observational study we evaluated compliance data in chronic users of SSRIs using electronic drug exposure monitors.
Results:
During a 3-month follow-up we found that 50/69 (72.5%) patients missed at least one dosing day and 20/69 (29.0%) missed two or more consecutive days.
Conclusions:
About 30% of patients treated with short-acting SSRIs had dosing lapses of 2 or more days, which, as described in prior studies, is long enough to result in clinically relevant deterioration of mental status.