Letters to the Editor
Medication Noncompliance Among Psychiatric Outpatients In Iran
Throughout the world, medication noncompliance is one of the major problems in psychiatric treatment. We have experienced this obstacle almost daily in our outpatient clinics in Iran. Medication noncompliance is defined as discontinuation of medications without physician recommendation. We should make clinicians aware that medication noncompliance is common and may be a relatively unpredictable phenomenon. Further, it can become a major treatment difficulty in psychiatric patients. We conducted a study in Kerman, Iran, which assessed 150 randomly selected psychiatric outpatients for medication noncompliance. Of the subjects, 56 (37.4%) had a history of early discontinuation of psychotropic medications. Medication noncompliance was more frequent in patients with primary school education than in those with high school education. False beliefs about psychotropic medications were significantly higher in patients who discontinued their treatment before the appointed time than in patients who continued.
The most prevalent false belief is that psychotropic medications are addictive. According to diagnosis, the highest rate of early discontinuation was seen among patients with depressive disorders. A high rate of medication noncompliance was also found in other studies (1,2).
Hopelessness, an important symptom, may be responsible for medication noncompliance in patients with depressive disorders. A false belief in psychotropic medications is a contributing factor to medication noncompliance in our country.
Patient compliance is an important factor for better therapeutic success; thus, for improved outcome, we recommend that psychiatrists evaluate patient compliance before prescribing psychotropic medications.
1. Gillis LS, Trollip D, Jakoet A, Holden T. Non-compliance with psychotropic medication. S AFR Med J 1987;72:602–6.
2. Ghazziuddin N, King CA, Hovey JD, Zaccagnini J, Ghaziuddin M. Medication noncompliance in adolescents with psychiatric disorders. Child Psychiatry Hum Dev 1999;30:103–10.
Alireza Ghaffari Nejad, MD
Fatemeh Pouya, MSc