Antidepressant Effectiveness

STAR*D Study Results

STAR*D was an NIH-funded study and it stands for: Sequenced Treatment Alternatives to Relieve Depression.  It was a seven-year study, involving more than 4,000 patients, making the largest and most definitive research we have available that underscores the inadequacies of currently available treatments.

Effectiveness of Antidepressant Trials

What the STAR*D study showed was that with each medication trial that a patient fails, the likelihood to respond to the next medication drops.

Tolerability of Antidepressants

At the same time, with each successive treatment trial, the likelihood of experiencing side effects increases.

Clearly, current antidepressant treatments do not result in a fully satisfactory outcome in a large proportion of patients with major depression.

References

• Fava, M., A. J. Rush, et al. (2006). "A Comparison of Mirtazapine and Nortriptyline Following Two Consecutive Failed Medication Treatments for Depressed Outpatients:  A Star*D Report." Am J Psychiatry 163(7): 1161-1172.
• McGrath, P. J., J. W. Stewart, et al. (2006). "Tranylcypromine Versus Venlafaxine Plus Mirtazapine Following Three Failed Antidepressant Medication Trials for Depression:  A STAR*D Report." Am J Psychiatry 163(9): 1531-1541.
• Nierenberg, A. A., M. Fava, et al. (2006). "A Comparison of Lithium and T3 Augmentation Following Two Failed Medication Treatments for Depression:  A STAR*D Report." Am J Psychiatry 163(9): 1519-1530.
• Rush, A. J. (2007). "STAR*D: What have we learned?" Am J Psychiatry 164(2): 201-204.
• Rush, A. J., M. H. Trivedi, et al. (2006). "Acute and Longer-Term Outcomes in Depressed Outpatients Requiring One or Several Treatment Steps: A STAR*D Report." Am J Psychiatry 163(11): 1905-1917.
• Trivedi, M. H., M. Fava, et al. (2006). "Medication Augmentation after the Failure of SSRIs for Depression." New England Journal of Medicine 354(12): 1243-1252.
• Trivedi, M. H., A. J. Rush, et al. (2006). "Evaluation of Outcomes with Citalopram for Depression Using Measurement-Based Care in STAR*D Implications for Clinical Practice." Am J Psychiatry 163(1): 28-40