November 1, 2006
The latest results in the landmark STAR*D study, funded by the National Institute of Mental Health (NIMH), and published today in the American Journal of Psychiatry, demonstrates the importance of giving people access to the best possible, most effective medication—right from the start.
Overall, almost 70% of patients with depression in the study were helped by one or more drugs. Approximately 40% achieved remission of symptoms on their first drug and 30% in the second. On the third and fourth tries, 14% and 13% respectively achieved remission. Treatment is often a progressive, incremental process.
In the real world, one size does not fit all. Managed care plans and state Medicaid formularies must not restrict threshold choices made by front-line physicians. The physician-patient relationship is critical in setting expectations and emphasizing the importance of staying on medication.
Greater scientific research is needed to achieve better, fast-acting, long-lasting alternatives.
Star*D results on the effectiveness of counseling also have not yet been published, which is a critical piece of the treatment puzzle.
Depression kills. Remission saves lives. Complete elimination of symptoms means a return to family, friends and productivity. The personal, social and economic benefits of effective treatment are enormous.
In 2005, NAMI conducted a survey that complements Star*D findings. On average, the majority of patients with depression who were surveyed had tried four medications. A majority experienced six or more episodes of depression in their lifetimes, but only 34% ever discussed the possibility of relapse with a physician. Less than 25% were aware of differences between full and partial remission of symptoms. Only 25% had received talk therapy or counseling.
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For more information on Sequenced Treatment Alternatives to Relieve Depression (STAR*D), please see the NIMH and Journal Web sites:
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