Antidepressant Medical Management


Major Depression is one of the most common mental illnesses effecting more than 20 million American adults each year. 1 Approximately, 60% of those treated for depression are cared for by Primary Care Physicians (PCPs) who prescribe almost 80% of their patients’ antidepressants. 2

Many patients who are prescribed antidepressants do not take their medication as prescribed. Commonly referred to as non-adherence, this can be caused by many factors such as patient beliefs, illness characteristics, social context, access, and service issues.  Barriers to adherence can include stigma, lack of understanding how the drug works, inadequate knowledge of the drug, fear of side effects or dependence, cost, and access. 3

Despite the demand placed on PCPs to treat depression, some practitioners may need resources to help them educate patients on the importance of medication adherence.  A checklist can be a valuable tool to help practitioners improve adherence with thorough patient education, opportunities for shared decision-making, and emphasizing the importance of follow-up appointments. 4

Checklist to improve patient education and shared decision-making:

1. Confirm the diagnosis and explain to the patient that it is a biological and treatable disorder.  Include examples of symptomology the patient reported.

2. Discuss any recommendation for pharmacological treatment based on the severity of symptoms, previous depressive episodes, current situation etc. Discuss patient expectations for medication.

3. Include the patient in the selection of an antidepressant and explain why one may be more effective than another based on age, gender, previous experiences, medical and psychiatric comorbidities.

4. Once a medication is chosen, explain to the patient:   

  • How the medication works, its advantages, and how to use it safely
  • It may take three to four weeks for the medication to have a noticeable impact on mood
  • How long treatment will last
  • Potential side effects, how long they usually last, and when to reach out with concerns
  • Dosage, scheduling and compliance recommendations
  • Lifestyle changes that need to be made such as avoiding caffeine and alcohol or increasing physical activity.

Additional Resources:

Behavioral Health Clinical Practice Guidelines 2021-2022

Antidepressant Medication Management HEDIS Tip Sheet

Link to Provider Educational Webinar  Information

Check out our AMM Provider Packet for printable member fliers on Medication Adherence, Using Medications Safely, and Talking with Your Pharmacist

American Medical Association