Patients' views of antidepressants: from first experiences to becoming expert

Background The majority of patients discontinue antidepressant treatment earlier than prescribed. The factors behind this and the influences on patients' choices about whether to take medication remain poorly understood. Aim To explore factors that influence patients' decisions about taking antidepressant medication. Design of study Qualitative interview study. Setting Interviews were conducted across three sites: London, East Lancashire, and North East England. Method Semi-structured interviews were conducted with a purposive sample of 65 primary care patients who were prescribed antidepressants in the past year for depression or mixed anxiety/depression. Results Participants described their first course of antidepressants as typically occurring when they had 'hit rock bottom', having exhausted all other possibilities; therefore, there was little sense of a positive choice at this stage. There would typically follow a period of experimentation where it was usual to stop and restart medication, often several times. Ultimately, these recurring cycles lead to participants becoming more expert about their condition and better able to make an informed decision about medication. For younger participants, recovery typically remained a goal, although for older people there was often an acceptance that their condition, and medication use, would be long term. Conclusion Participants' accounts demonstrated how they could become expert at managing their condition through a process of trial and error.