The STAR*D trial: revealing the need for better treatments

Psychiatr Serv. 2009 Nov;60(11):1466-7. doi: 10.1176/ps.2009.60.11.1466.


STAR*D (Sequenced Treatment Alternatives to Relieve Depression) continues to stimulate debate. The landmark trial demonstrated the feasibility of large-scale, community-based studies conducted without pharmaceutical company support. The results provided insight into nonresponse to initial treatment with selective serotonin reuptake inhibitors and alternatives for second- and third-line treatment options and suggested opportunities for personalized approaches to depression care. However, initial and one-year remission rates (28% and 70%, respectively) suggest that important goals for treatment of this disabling disease remain out of reach and that the bar for antidepressants has been set far too low.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Depressive Disorder, Major / drug therapy*
  • Depressive Disorder, Major / therapy
  • Humans
  • Precision Medicine
  • Remission Induction
  • Serotonin Uptake Inhibitors / therapeutic use
  • Treatment Failure
  • Treatment Outcome


  • Serotonin Uptake Inhibitors