New strategies help depressed patients become symptom-free

Results of the nation's largest depression study show that one in three depressed patients who previously did not achieve remission using an antidepressant became symptom-free with the help of an additional medication and one in four achieved remission after switching to a different antidepressant. The study, funded by the National Institutes of Health's National Institute of Mental Health (NIMH), shows that people whose depression is resistant to initial treatment can achieve remission the virtual absence of symptoms when treated with a secondary strategy that either augments or switches medications. This is the first study to examine the effectiveness of different treatment strategies for those who did not become symptom-free after initial medication.

John Rush, M.D., and Madhukar H. Trivedi, M.D., of the University of Texas Southwestern Medical Center (UTSWMC), and colleagues report on the first major results of the clinical trial, known as the STAR*D (Sequenced Treatment Alternatives to Relieve Depression) study, in two papers published in the March 23, 2006 issue of the New England Journal of Medicine.

"These findings provide important treatment options to mental health clinicians and millions of Americans who struggle with treatment-resistant depression," said NIH Director Elias A. Zerhouni.

Patients who did not experience a remission of symptoms during the first level of the STAR*D study in which they initially took the antidepressant citalopram, a selective serotonin reuptake inhibitor (SSRI) for up to 14 weeks had the option of continuing to level 2 of the trial where they could explore additional treatment options designed to help them become symptom-free.

"If the first treatment attempt fails, patients should not give up," said NIMH's director Thomas Insel, M.D. "By remaining in treatment, and working closely with clinicians to tailor the most appropriate next steps, many patients may find the best single or combin

Contact: NIMH Press Office
NIH/National Institute of Mental Health

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