STAR*D Dethroned?

Since 2006, STAR*D stands out as an icon guiding treatment decisions of major depressive disorder. But what if it is broken?

This article by Dr. John J. Miller has been published in Psychiatric Times. It begins:

“In the treatment of major depressive disorder (MDD), the acronym STAR*D stands out as a beacon guiding treatment decisions since 2006 when a series of publications reported the results from this massive, $35 million National Institute of Mental Health (NIMH)–funded research study.

Recently, a provocative and well-researched publication in the BMJ reanalyzed the original raw data obtained from the NIMH and challenged the conclusions of the STAR*D publications.

The Sequenced Treatment Alternatives to Relieve Depression (STAR*D) was a prospective study that began with 4041 adults diagnosed with a current major depressive episode who were treated in 41 participating psychiatric and primary care treatment clinics. These patients entered the treatment protocol, which included up to 4 consecutive pharmacological regimens, called steps, lasting 12 to 14 weeks each, with the primary outcome of achieving remission predefined as a score < 8 on the blinded Hamilton Rating Scale for Depression (HRSD).1,2…”

You can read more from here.

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