Medication Adherence in Children and Adolescents with Major Depressive Disorder

Major Depressive Disorder (MDD) is a serious psychiatric disorder in children and adolescents where antidepressant adherence remains an important issue. The present study uses electronic monitoring (Medication Event Monitoring System, APREX, Fremont, California [MEMS® caps]) to compare various methods of measuring adherence. Subjects who met the Diagnostic and Statistical Manual of Mental Disorders' (DSM-IV) criteria for MDD participated in a randomized controlled trial involving fluoxetine. A subset of patients had their medication adherence monitored for up to 12 weeks using MEMS caps, blood levels, self-report, medication diaries, physicians' estimates, and pill counts. Throughout the 12-week process, patients also completed a number of questionnaires assessing treatment expectancy, side effects, family functioning, school functioning, cognitive beliefs, depressive symptoms, and the identity of the individual(s) dispensing medication.