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Clinical guidelines recommend that past antidepressant use trajectories should inform decisions on discontinuation after cancer diagnosis.<\/jats:p><jats:p>We characterized AYAs' antidepressant adherence trajectories before incident cancer diagnosis and assessed any association between their past adherence trajectory and the risk of antidepressant discontinuation up to 1\u2009year afterward.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective, longitudinal cohort study of AYAs receiving \u2265\u20092 antidepressant fills 9\u2009months before incident cancer diagnosis (index date). Group\u2010based trajectory modeling was used to estimate latent subgroups of antidepressant adherence before cancer diagnosis, using monthly proportions of days covered (PDC) over the nine\u2010month baseline; IQVIA PharMetrics Plus for Academics US claims, 2006\u20132020. Discontinuation was defined as \u2265\u200960\u2010days gap without antidepressants within 1\u2009year post\u2010index date.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We observed three distinct antidepressant adherence trajectory groups before cancer diagnosis: <jats:italic>recent start<\/jats:italic> (17% of cohort, mean PDC [range]: 0.25 [0.03\u20130.49]); <jats:italic>gradually increasing<\/jats:italic> (36%, mean PDC [range]: 0.57 [0.22\u20130.81]); and <jats:italic>consistently high<\/jats:italic> (47%, mean PDC [range]: 0.90 [0.62\u20131.00]). Compared with AYAs exhibiting prior <jats:italic>consistently high<\/jats:italic> adherence trajectories, those with <jats:italic>recent start<\/jats:italic> (HR, [95% CI] 1.96, [1.46\u20132.63]) and <jats:italic>gradually increasing<\/jats:italic> (HR, [95% CI] 1.52, [1.20\u20131.93]) trajectories experienced about 2 times the higher risk of antidepressant discontinuation over the year following cancer diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Past antidepressant trajectory is associated with antidepressant discontinuation after AYA cancer diagnosis. Attention is needed in the psycho\u2010oncologic care of AYAs who recently started antidepressants before cancer diagnosis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.70131","type":"journal-article","created":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T16:37:53Z","timestamp":1743093473000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Antidepressant Use Trajectories and Risk of Discontinuation After Adolescents and Young Adult Cancer Diagnosis"],"prefix":"10.1002","volume":"34","author":[{"given":"Oluwadamilola","family":"Onasanya","sequence":"first","affiliation":[{"name":"Department of Practice, Sciences, and Health Outcomes Research University of Maryland School of Pharmacy  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Udim","family":"Damachi","sequence":"additional","affiliation":[{"name":"Department of Practice, Sciences, and Health Outcomes Research University of Maryland School of Pharmacy  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2210-6650","authenticated-orcid":false,"given":"Susan","family":"dosReis","sequence":"additional","affiliation":[{"name":"Department of Practice, Sciences, and Health Outcomes Research University of Maryland School of Pharmacy  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1336-8106","authenticated-orcid":false,"given":"Wendy","family":"Camelo Castillo","sequence":"additional","affiliation":[{"name":"Department of Practice, Sciences, and Health Outcomes Research University of Maryland School of Pharmacy  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,3,25]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.45.9222"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.31887\/DCNS.2015.17.2\/epark"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1089\/jayao.2020.0180"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2013.03.017"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.1860"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.31942"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.2016.011072"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clbc.2021.10.003"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdz173"},{"key":"e_1_2_12_11_1","unstructured":"FDA \u201cResearch C for DE and. 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