<![CDATA[Depression represents a global health burden with a high risk of disability, where antidepressant pharmacological therapy serves as the primary modality, yet its effectiveness is often hindered by low patient adherence leading to treatment resistance and relapse. This study aims to analyze the determinant factors affecting medication adherence in patients with depressive disorders based on empirical evidence from the last five years. The method employed was a narrative literature review with literature searches conducted on reputable academic databases including PubMed, SAGE, MDPI, and Google Scholar, with inclusion criteria of articles published between 2021–2025. Synthesis of 11 selected studies indicates that non-adherence is influenced by complex multifactorial interactions, where drug side effects, particularly sexual dysfunction and weight gain, act as the primary barriers in 73% of cases. A recent 2025 study also highlights the phenomenon of loss of responsiveness upon reinstatement of therapy after discontinuation, which worsens long-term prognosis. Additionally, physical comorbidities such as hypertension and chronic obstructive pulmonary disease, along with psychological factors including depression severity and lack of family support, significantly contribute to low adherence. It is concluded that adherence to antidepressant therapy is heavily influenced by side effect tolerability and psychosocial factors, thus clinical management strategies must integrate drug selection with minimal side effect profiles and strengthen patient education to prevent early discontinuation.]]>
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