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A Follow-up to the STAR*D Results

I just wanted to write a quick follow-up to the two studies published earlier this week in the New England Journal of Medicine on the STAR*D research initiative.

A lot of the news stories written since these results were published suggest a very positive view of the study. For instance, the Associated Press’s medical writer suggested:

Up to one-third of those who added or changed medicines recovered from the crushing illness that is America’s top mental health problem, researchers said.

This is good news by itself, but the bigger picture is even more encouraging, doctors say. When viewed with earlier results, the new findings mean that roughly half of people who suffer from depression can get over it — not just improve their symptoms — with adequate medication.

But this kind of statement is really clouding the picture of what the current two studies show — that two-thirds of patients who try at least 2 different antidepressant medications over the course of 6+ months still do not find significant clinical improvement in their symtpoms. Six months and little improvement.

Doctors have long known — and have long done — what these studies are showing; using trial-and-error practice, physicians go through a number of antidepressants until they find one that works for an individual. They usually don’t wait 12 or 14 weeks like these studies did, but the studies do show that it is probably beneficial to do so since some people may not feel the effects of the medications until after that time.

Of course, with such a narrow emphasis on medication-only treatment of depression, these results are not surprising. There are a multitude of other studies from the past two decades that show that this is not the best standard of care for depression — medications combined with psychotherapy is. It would be interesting to see the results of a modern, large-scale study that examined such a combination.

A Follow-up to the STAR*D Results

John M. Grohol, Psy.D.

Dr. John Grohol is the founder & CEO of Psych Central. He is an author, researcher and expert in mental health online, and has been writing about online behavior, mental health and psychology issues -- as well as the intersection of technology and human behavior -- since 1992. Dr. Grohol sits on the editorial board of the journal Computers in Human Behavior and is a founding board member and treasurer of the Society for Participatory Medicine. He writes regularly and extensively on mental health concerns, the intersection of technology and psychology, and advocating for greater acceptance of the importance and value of mental health in today's society. You can learn more about Dr. John Grohol here.


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APA Reference
Grohol, J. (2018). A Follow-up to the STAR*D Results. Psych Central. Retrieved on February 18, 2019, from https://psychcentral.com/blog/a-follow-up-to-the-stard-results/
Scientifically Reviewed
Last updated: 8 Jul 2018
Last reviewed: By a member of our scientific advisory board on 8 Jul 2018
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