A patient with a history of depression has stopped taking prescribed antidepressants. Which approach by the nurse is most therapeutic?

• A. Encourage discussion about obstacles to medication adherence and problem-solve with the patient.
• B. Switch to a different class of antidepressants immediately.
• C. Ignore non-adherence to avoid conflict.
• D. Tell the patient to resume medication without discussing barriers.

Answer: (A)

Therapeutic communication that explores barriers to adherence and collaborates on solutions is most effective. When a patient with depression has stopped antidepressants, reasons can include bothersome side effects, cost, forgetfulness, stigma, or doubts about efficacy. By inviting the patient to discuss these obstacles in a nonjudgmental way, the nurse can identify specific challenges and work with the patient to address them—such as adjusting dosing, managing side effects, setting reminders, arranging follow-up, or considering alternative treatments. This approach strengthens the therapeutic relationship, supports the patient’s autonomy, and helps maintain or improve adherence, reducing the risk of relapse. Dismissing non-adherence, telling the patient to resume without discussion, or changing medications without addressing underlying barriers misses the opportunity to solve the root causes and is less likely to help the patient stay adherent.