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Initial Results Help Clinicians Identify Patients with Treatment-Resistant Depression

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Brief Description:
Initial results of the nation's largest clinical trial for depression have helped clinicians to track "real world" patients who became symptom-free and to identify those who were resistant to the initial treatment.

Transcript:
Schmalfeldt: Each year, about nine-point-five percent of the population — that's about 19 million Americans, will struggle with depressive illness. The World Health Organization says depression is the fourth most disabling illness worldwide. At present, there is only limited information about how to successfully treat people with depression, especially those who have not gotten better with the first treatment tried, according to Doctor Thomas Insel, director of the National Institute of Mental Health.

Insel: What do you do next? Do you put them on another one, do you keep them on the same drug longer, do you add a second drug to the first drug, do you add psychotherapy to medication treatment? The STAR*D trial, which is a trial of over four thousand people with depression is looking at just that question to provide very practical guidance for patients and doctors to know what to do for treating depression.

Schmalfeldt: The STAR*D Study — that stands for Sequenced Treatment Alternatives to Relieve Depression — is the largest and longest study ever done to evaluate depression treatment. Initial results of the nation's largest clinical trial for depression have helped clinicians to track "real world" patients who became symptom-free and to identify those who were resistant to the initial treatment. Over a seven-year period, over four thousand outpatients, ranging in age from 18 to 75, were enrolled in the study. About a third of participants reached a remission or virtual absence of symptoms during the initial phase of the study, with an additional 10 to 15 percent experiencing some improvement.

Insel: What we don't know is who's going to respond to which drug? Are the drugs roughly equivalent? And if they're equivalent, we know they're not identical. So, what we need to know is how can we predict who's going to get better on a trial of a drug.

Schmalfeldt: Subsequent phases of the trials will help determine successful treatments for the nearly two thirds of those patients who were identified as treatment-resistant to a first medication in phase one. For more information, visit www.nimh.nih.gov. From the National Institutes of Health, I'm Bill Schmalfeldt in Bethesda, Maryland.

This page was last reviewed on June 28, 2006 .

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