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The STAR*D Trial

The STAR*D Trial. Treating depression in the real world Albreka Hudson, Pharmd Candidate Ron Beasley, pharmd candidate Preceptor: soheYla mahdavian , pharmd. The StarD Tria l. S equenced T reatment A lternatives to R elieve D epression 

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The STAR*D Trial

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  1. The STAR*D Trial Treating depression in the real world Albreka Hudson, Pharmd Candidate Ron Beasley, pharmd candidate Preceptor: soheYlamahdavian, pharmd

  2. The StarD Trial Sequenced Treatment Alternatives to Relieve Depression  Overall assessment of the nation's largest real-world study of treatment-resistant depression Conclusions funded by NIMH Published in the American Journal of Psychiatry on November 1, 2006.

  3. Objectives What to do next when patients fail to respond to a standard trial of treatment with an antidepressant medication? What order or sequence? What combination(s) are both acceptable to patients and provide the best clinical results with the least side effects?

  4. STAR*D: An Efficacy Trial • Broad inclusion criteria • Suicidal patients in depression trials • Publicly and privately insured • Private and specialty care settings • Compared active treatments rather than active treatment against placebo • Remission vs. response • Focused on real-world measurement-based care • Functioning • Efficacy vs. effectiveness •  Use of pharmacologic and psychosocial treatment options • cognitive-behavioral therapy • Randomized clinical equipoise design • Assignment to different treatment arms

  5. Treatment Algorithm

  6. References 1. Zimmerman M, Chelminski I, Posternak MA. Generalizability of antidepressant efficacy trials: differences between depressed psychiatric outpatients who would or would not qualify for an efficacy trial. Am J Psychiatry. 2005;162(7):1370 –1372. 2. Rush AJ, Prien RF. From scientific knowledge to the clinical practice of psychopharmacology: can the gap be bridged? Psychopharmacol Bull. 1995;31(1):7–20. 3. Khan A, Schwartz K. Study designs and outcomes in antidepressant clinical trials. EssentPsychopharmacol. 2005;6(4):221–226. 4. http://www.ccjm.org/content/75/1/57.full.pdf

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