Abstract
Background: The present study determined the prescription pattern of antidepressants, adverse drug reactions (ADRs), the level of adherence, and factors affecting it.
 Methods: This prospective cross-sectional study was conducted with depression patients (n=174; 55.74% female) from August 2019 to November 2019 at a psychiatric hospital of Pokhara, Kaski, Nepal. The Naranjo ADR Probability Scale was employed to assess the ADRs. The rate of medication adherence (MA) was determined using Morisky MA Measurement Scale-Eight. Descriptive statistics (median, interquartile range, frequency, and percentage), bivariate analysis, and Chi-square test were used; p<0.05 was taken as significant in multivariate analysis.
 Results: Selective serotonin reuptake inhibitors (SSRIs) were found to be the most commonly prescribed antidepressants (58.04%) followed by serotonin and noradrenaline reuptake inhibitors (SNRIs; 13.79%). More than half of the patients had a low level of adherence (52.29%) and about 74.13% experienced ADR. The most common ADRs were insomnia (17.05%) and anxiety (17.05%). Female were found to be more non-adherent compared to male (odds ratio 1.011; 95% confidence interval; 0.507–1.832). The level of adherence was found to be associated with the probability and severity of ADR.
 Conclusion: The majority of patients used SSRIs. ADRs were more prevalent. However, adherence to medications was extremely poor in the hospital, which was attributed to factors such as gender, occupation, education, and ADRs.
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