Improving Medication Compliance in Patients with Depression: Use of Orodispersible Tablets

The treatment of major depressive disorder requires prolonged pharmacotherapy with antidepressants in order to resolve the current episode and reduce the risk for recurrence of depressive symptoms. Such prolonged therapy requires considerable commitment on the part of patients to take their medication as prescribed. Medication compliance is often poor among psychiatric patients, including those with major depressive disorder; this can result in poor long-term outcomes and, ultimately, treatment failure. The onus lies with the prescribing physician to support patients in complying with their medication regimen. Establishing and maintaining a supportive therapeutic relationship is an essential foundation for ensuring patient compliance. Difficulty in swallowing conventional tablets and capsules has emerged as an additional factor in medication noncompliance and has led to the development of alternative drug delivery strategies such as orodispersible tablets (ODTs). ODTs are associated with improved medication compliance compared with traditional tablet formulations. An ODT formulation of the antidepressant mirtazapine has been available since 2001 and an ODT formulation of escitalopram is currently in development. Such formulations offer convenient alternatives to traditional tablets and may support patient compliance with extended therapy. This review discusses practical methods of improving compliance in patients with depression with a particular focus on ODTs.