Discontinuation of Antidepressant Medication Among Latinos in the USA

Heller School for Social Policy and Management, Brandeis University, Волтам, Massachusetts, United States
The Journal of Behavioral Health Services & Research (Impact Factor: 1.37). 08/2007; 34(3):329-42. DOI: 10.1007/s11414-007-9070-6
Source: PubMed


Despite recent growth in the variety of antidepressant medications available, many patients discontinue medication prematurely for reasons such as nonresponse, side effects, stigma, and miscommunication. Some analysts have suggested that Latinos may have higher antidepressant discontinuation rates than other US residents. This paper examines Latino antidepressant discontinuation, using data from a national probability survey of Latinos in the USA. In this sample, 8% of Latinos had taken an antidepressant in the preceding 12 months. Among those users, 33.3% had discontinued taking antidepressants at the time of interview, and 18.9% had done so without prior input from their physician. Even controlling for clinical and other variables, patients who reported good or excellent English proficiency were less likely to stop at all. Patients were also less likely to stop if they were older, married, had public or private insurance, or had made eight or more visits to a nonmedical therapist.

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Available from: Margarita Alegria, Oct 10, 2014
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    • "Excluded from this table are the results of review studies and the original articles of Edlund et al. (2008); Einarson (2009); Hirschfeld (1998); Hirschfeld et al. (1997); Schraufnagel et al. (2006); Meredith et al. (2009); and Hodgkin et al. (2007). "
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    ABSTRACT: The aim of this study was to ascertain whether there is any evidence of stigma related to the use of antidepressants. Using the PubMed and MEDLINE databases, we searched for the terms stigma, antidepressants, and depression. A protocol was developed to extract information from the papers, which were identified and explored further. Thirty-two papers were identified. We found that the stigma against depression differs from stigma against the use of antidepressants. Stigma against depression does not impact on therapeutic adherence to antidepressant use. Stigma related to antidepressant use appears to be linked with perceived emotional weakness, severity of illness, an inability to deal with problems, and a lack of belief in the therapeutic efficacy of antidepressants. Stigma against medication can be a useful target for interventions, just like the stigma related to depression. However, clinicians must be careful in avoiding the medicalization of symptoms.
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    • "Other predictors of poor adherence cannot be modified by treating clinicians. Examples of the latter include low level of education81 and/or poor English-language proficiency,23 psychosocial immaturity,122,123 and disadvantaged economic23,82,124 and/or family functioning123–125 circumstances. Although clinicians always should communicate in a clear, easily understood manner,47,53 this is especially necessary in situations where the latter adverse predictors are prominent. "
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    • "Although US studies about stigma in Latino patient populations are very few and mostly exploratory, the evidence is highly suggestive. Both quantitative and qualitative reports underscore concerns, especially among foreign-born and less acculturated Latinos, regarding labeling, embarrassment and social discrimination from family, friends and employers impeding acceptance of depression treatment and medication adherence [12] [13] [14]. "
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