Compliance with tricyclic antidepressants: the value of four different methods of assessment.

Aims: To assess the advantages and disadvantages of four methods for studying compliance with antidepressants: self-report scores, tablet counts, a microprocessor (MEMS) container system and the assay of nordothiepin and dothiepin concentrations in plasma.

Methods: The techniques were used in 88 patients commencing tricyclic antidepressants in the setting of UK general practice.

Results: The MEMS system proved to be the most informative technique allowing identification of the precise time of container opening, the demonstration of 'drug holidays' and early cessation of therapy.