Treatment adherence research

Adherence to anxiety treatment, both medication and therapy, is incomplete in real-world settings. A meaningful share of patients stop antidepressants within the first few months, often before the medication has had a full chance to work. Therapy has dropout as well, since CBT requires attending sessions and doing practice between them.

The research identifies several recurring reasons. Side effects are a major driver of stopping medication, particularly sexual side effects with SSRIs. The slow onset of antidepressants matters too. A person who expects fast relief and feels none in the first two weeks may stop before the four-to-six-week window in which benefit usually appears. Cost, insurance gaps, the burden of appointments, stigma, and simply feeling better and deciding the treatment is no longer needed all contribute.

Adherence is also why real-world results often fall short of trial results. A treatment can have strong efficacy in a trial and a weaker effect in practice, not because the treatment changed, but because fewer people took it as intended.