OBJECTIVES: The aim of this study was to determine the impact of antidepressant adherence on health-related quality of life and life satisfaction in a representative community sample of older adults.  METHODS: The data were obtained from the ESA (Étude sur la Santé mentale des Aînés) Services study that included a large sample of older adults (n=1809) aged 65 years and over who consulted and were recruited in a primary care practices. HRQOL was measured using the EuroQOL-5D which assessed utility values, from the general population perspective and the EQ-Visual Analog Scale (EQ-VAS) was used to measure self-reported health status from the patient perspective. The CASP was used to measure life satisfaction. Common mental disorders were based on DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) criteria. Antidepressant use was obtained from administrative databases. A 4 level dummy variable was constructed to consider the presence of depression/anxiety (MD) and antidepressant use (MD X AD). Adherence to antidepressant was measured using the medication possession ratio (MPR ≥ 80%). Multivariate linear regression models were used to study HRQOL and life satisfaction as a function of depression/anxiety X antidepressant use (MD X AD) controlling for antidepressant use, the presence of chronic and physical disorders and other socio-demographic factors.  RESULTS: HRQOL measured by the EuroQOL was significantly associated with age, cognitive impairment and the presence of depression. Self-reported health status measured by the EQ-VAS was associated with age, number of chronic illnesses, cognitive impairment. The CASP was associated with age, and PTSD. Antidepressant use was associated with a lower HRQOL and a lower life satisfaction.  CONCLUSIONS: The study showed that the determinants associated with HRQOL and life satisfaction from the patient and general population perspective differs. Future studies should focus on determining other factors that influence HRQOL and life satisfaction in older adults.