7. What do the STAR*D results mean to people with MDD and their doctors?

A. The results reiterate the need for high-quality care and attention to the individual needs of patients. Doctors should provide medication at optimal doses, be aware of and offer treatment choices, and maintain diligent monitoring of patients both during treatment and after they become symptom-free so as to avoid relapse.

Like other medical illnesses, depression affects different people in different ways, but a wide range of effective treatments exist. People with depression should not give up if their initial treatment attempts do not result in full benefits. They should continue to work with their doctors to find the best treatment strategy.

In addition, patience is required. While some people may experience benefits in the first six weeks of a treatment strategy, full benefits may not be realized until 10 or 12 weeks have passed. During this time, doctors should work with their patients to adjust dosages so as to find an optimal level, and avoid stopping a treatment prematurely.

8. What more will be learned from the STAR*D study and what areas of future research will be influenced by STAR*D?

A. The STAR*D study results published to date provide important information about the effectiveness of current treatments in primary care and specialty settings in real world patients. Subsequent analyses of the STAR*D data include:

  • results of cognitive therapy as a switch and add-on treatment;
  • factors affecting patient preferences in choosing next-step treatments when a first treatment is not successful;
  • comparison of the effectiveness of different treatments in preventing relapse; and
  • factors associated with relapse.

Also, blood samples that were voluntarily collected from more than 1,900 of the STAR*D participants will allow researchers to identify potential biological markers of disease course and treatment response.

The results of STAR*D also underscore the need for more effective treatment strategies and more patient-tailored interventions for the treatment of major depression. Future research topics beyond STAR*D include:

  • developing methods to predict who will respond to which treatment and in what treatment sequence; and
  • evaluating combination medication strategies earlier in the course of treatment compared to single therapy strategies.