Thirty percent of chronically depressed patients achieve remission
during initial treatment with a selective serotonin reuptake
inhibitor (SSRI), according to initial results of a federally funded study.
The $35 million, 2,876-subject study, known as STAR*D, was funded
by the National Institute of Mental Health and focused on recovery.
A substantial number achieved remission or response at or around
eight weeks of treatment, study data published in the January 2006
issue of American Journal of Psychiatry show.
The data suggest new guidelines for clinicians treating these
patients. Those treated successfully received close monitoring and
frequent dose adjustments in the first three months.
While most US patients don’t receive this level of care, the
researchers created a rating system that can be used by any
physician to help tailor treatment.
Patients who experienced remission also took higher than typical
doses of Forest Labs antidepressant Celexa (citalopram).
Lead author Dr. Madhukar Trivedi, of the University of Texas
Southwestern Medical Center, stressed that the odds of benefit
should be similar with any first-choice SSRI. Celexa was chosen for
research-oriented reasons, including once-daily dosing.
Identifying alternatives for hard-to-treat patients—the main study
objective—won’t be completed for a few months.