Third of patients recover on first SSRI they try: study

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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.
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