Document Title: Compliance With Anti-Depressant Medication Among Prison Inmates With Depressive Disorders Author(s):

Objective: The study assessed correlates of anti-depressant medication compliance among Texas Department of Criminal Justice (TDCJ) prison inmates. Methods: The study population consisted of 5,305 TDCJ inmates who were diagnosed with one of three depressive disorders: major depression, dysthymia, and bipolar disorder. The primary outcome measure under study was anti-depressant medication compliance. Information on medical conditions, sociodemographic factors, and medication compliance was obtained retrospectively from an institution-wide medical information system. Results: TDCJ inmates treated with selective serotonin reuptake inhibitors (SSRIs) did not exhibit improved medication compliance cornpared to those treated with tricyclic antidepressants TCAs. In fact, among inmates with all depressive disorders and bipolar disorders, those treated with TCAs exhibited greater compliance, even when adjusting for sociodemographic factors. Moreover, among inrnates with depressive disorders male gender, black race, and older age were positively associated with medication compliance scores. Conclusion: This investigation provides no evidence that expanded SSRI use would improve adherence to pharmacologic treatment of depressive disorders in the Texas prison system. Our findings also suggest that correctional administrators may wish to target younger inmates and females with interventions to improve medication compliance.