title: The STAR*D trial: revealing the need for better treatments.
abstract: 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.
authors.affiliation: National Institute of Mental Health, Bethesda, MD 20892-9669, USA. insel@mail.nih.gov
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Insel
authors.forename: Philip S
authors.initials: PS
authors.lastname: Wang
mesh_terms: D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000628:therapy; D006801:Humans; D057285:Precision Medicine; D012074:Remission Induction; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors