This retrospective cohort followed 76,200 new antidepressant users with mood or anxiety disorders in Manitoba from 2015 to 2021. Outpatient dispensing data defined persistence as refilling the index drug with no gap over 60 days. Persistence was 56%, 41%, 33% and 25% at 3, 6, 9 and 12 months. Income assistance (OR 0.57) and tricyclics versus SSRIs (OR 0.31) predicted lower 12-month persistence. Male sex (OR 0.87), age under 25 (OR 0.74) and prior PTSD (OR 0.83) also predicted lower persistence. Dispensing records only proxy actual use, and switching to another antidepressant counted as discontinuation.
Why it is interesting: Three in four new users stopped their first antidepressant within a year, short of the recommended 6 to 12 months. Persistence also varied with income assistance, drug class and region within a universal health system.
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