Trial reportJournal of the American Academy of Child and Adolescent Psychiatry2011
Pharmacokinetically and clinician-determined adherence to an antidepressant regimen and clinical outcome in the TORDIA trial.
Trial report in Journal of the American Academy of Child and Adolescent Psychiatry, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00018902 (Treatment of SSRI-Resistant Depression in Adolescents), which is not on this map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Treatment of SSRI-Resistant Depression in Adolescents (TORDIA)
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.
- A systematic review of interventions for treatment resistant major depressive disorder in adolescents.European child & adolescent psychiatry · 2020Pooled it
- Measures of Connectivity and Dorsolateral Prefrontal Cortex Volumes and Depressive Symptoms Following Treatment With Selective Serotonin Reuptake Inhibitors in Adolescents.JAMA network open · 2023Trial
- Out of the black box: treatment of resistant depression in adolescents and the antidepressant controversy.Journal of child and adolescent psychopharmacology · 2012Trial
- Resting-state functional connectivity of the default mode network as a predictor for escitalopram response in adolescents with depression.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026Article
- Electronically Monitored Antidepressant Adherence in Adolescents with Anxiety Disorders: A Pilot Study.Journal of child and adolescent psychopharmacology · 2025Article
- Persistence with daily growth hormone among children and adolescents with growth hormone deficiency in Japan.PloS one · 2025Article
- Parental Factors Associated with Child or Adolescent Medication Adherence: A Systematic Review.Healthcare (Basel, Switzerland) · 2023Review
- Predictors, Moderators, and Mediators Associated With Treatment Outcome in Randomized Clinical Trials Among Adolescents With Depression: A Scoping Review.JAMA network open · 2022Article
- Pediatric Therapeutic Drug Monitoring for Selective Serotonin Reuptake Inhibitors.Frontiers in pharmacology · 2021Article
- Annual Research Review: Defining and treating pediatric treatment-resistant depression.Journal of child psychology and psychiatry, and allied disciplines · 2020Review
- CYP2C19-Guided Escitalopram and Sertraline Dosing in Pediatric Patients: A Pharmacokinetic Modeling Study.Journal of child and adolescent psychopharmacology · 2019Article
- Distinct Profiles on Subjective and Objective Adherence Measures in Patients Prescribed Antidepressants.Drugs · 2019Review
- Pharmacotherapy Adherence for Pediatric Anxiety Disorders: Predictors and Relation to Child Outcomes.Child & youth care forum · 2018Article
- Common Factors in Pediatric Psychiatry: A Review of Essential and Adjunctive Mechanisms of Treatment Outcome.Journal of child and adolescent psychopharmacology · 2017Review
- Primary Pediatric Care Psychopharmacology: Focus on Medications for ADHD, Depression, and Anxiety.Current problems in pediatric and adolescent health care · 2017Review
- Long-Term Use of Selective Serotonin Reuptake Inhibitors and Risk of Glaucoma in Depression Patients.Medicine · 2015Observational
- Pediatric depression: an evidence-based update on treatment interventions.Current psychiatry reports · 2013Review
- Prevalence, comorbidities and outpatient treatment of anorexia and bulimia nervosa in German children and adolescents.Eating and weight disorders : EWD · 2013Article
- To adhere or not, and what we can do to help.European child & adolescent psychiatry · 2012Article
- The use of cognitive behavioral therapy in the treatment of resistant depression in adolescents.Adolescent health, medicine and therapeutics · 2012Review
Corrections and comments
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Authors and funding
14 authors at 7 institutions in 1 country.
Funding
Abstract
objectiveNonadherence to antidepressant treatment may contribute to poor outcome and to suicidal adverse events in adolescent depression. We examine the relationship between adherence and both clinical response and suicidal events in participants in the Treatment of Resistant Depression in Adolescents (TORDIA) study.
methodThe relationship between adherence to medication and clinical outcome was assessed in 190 treatment-resistant depressed adolescents who were randomized to one of four cells: switch to another selective serotonin reuptake inhibitor (SSRI), switch to venlafaxine, or either of these two medication switches plus cognitive behavioral therapy. Plasma levels of antidepressant drug and metabolites were determined after 6 and 12 weeks of treatment. A twofold or greater variation in the dose-adjusted concentration of drug plus metabolites (level/dose ratio [LDR]) was defined as nonadherence. Nonadherence was also determined by clinician pill counts (CPC) of the proportion of prescribed pills that were unused and was defined as having greater than 30% of the prescribed pills remaining.
resultsLDR and CPC showed low concordance. LDR was unrelated to clinical response. CPC adherence was related to a higher response rate overall (adherent, 63.0% versus nonadherent, 47.2%, p = .03). Approximately half (50.8%) of the sample surveyed showed evidence of nonadherence by CPC. Neither measure of adherence was related to the occurrence of suicidal events or to the pace of decline in suicidal ideation.
conclusionsClinician pill counts may be a relevant measure of adherence that is related to outcome under formal clinical trial conditions in depressed adolescents. Nonadherence appears to be a common and significant source of treatment nonresponse. Clinical Trial Registration Information-Treatment of SSRI-Resistant Depression in Adolescents (TORDIA); http://www.clinicaltrials.gov; NCT00018902.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.