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Randomized Controlled Trial
. 2009 Nov;60(11):1466-7.
doi: 10.1176/ps.2009.60.11.1466.

The STAR*D Trial: Revealing the Need for Better Treatments

Randomized Controlled Trial

The STAR*D Trial: Revealing the Need for Better Treatments

Thomas R Insel et al. Psychiatr Serv. .


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.

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