Limitations in efficacy of antidepressant monotherapy.
Treatment for major depressive disorder does not achieve remission in about 50% of patients following 2 treatment trials. Researchers conducted the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study to compare various treatments for efficacy and tolerability. This article will focus on the efficacy of antidepressant monotherapy as determined by the STAR*D trial. Patients in the first treatment step of STAR*D received citalopram monotherapy and, depending on their response, moved either to follow-up or through a series of up to 4 additional treatment steps, each comprising different monotherapies, combinations, or augmentation treatment options. Only 1 of 3 patients remitted with the initial monotherapy. Rates of remission for each consecutive monotherapy were increasingly lower, suggesting that a series of monotherapy options may not be the best treatment strategy for patients who are nonresponsive to an initial monotherapy.
Rush
A John
AJ
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390-9066, USA. john.rush@utsouthwestern.edu
D000293:Adolescent; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D015283:Citalopram / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003865:Major Depressive Disorder / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D000928:Antidepressive Agents; D015283:Citalopram