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J Clin Psychiatry. 2007;68 Suppl 10:8-10.

Limitations in efficacy of antidepressant monotherapy.

Author information

1
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390-9066, USA. john.rush@utsouthwestern.edu

Abstract

Treatment for major depressive disorder does not achieve remission in about 50% of patients following 2 treatment trials. Researchers conducted the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study to compare various treatments for efficacy and tolerability. This article will focus on the efficacy of antidepressant monotherapy as determined by the STAR*D trial. Patients in the first treatment step of STAR*D received citalopram monotherapy and, depending on their response, moved either to follow-up or through a series of up to 4 additional treatment steps, each comprising different monotherapies, combinations, or augmentation treatment options. Only 1 of 3 patients remitted with the initial monotherapy. Rates of remission for each consecutive monotherapy were increasingly lower, suggesting that a series of monotherapy options may not be the best treatment strategy for patients who are nonresponsive to an initial monotherapy.

PMID:
17900203
[Indexed for MEDLINE]

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