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A Review of the STAR*D Trial

University of Connecticut Institute of Living, Burlingame Center, Hartford

Benjamin Chavez, PharmD

Rutgers, State University of New Jersey, Ernest Mario School of Pharmacy, 160 Frelinghuysen Road, Piscataway, NJ 08854, ufrxchavez{at}aol.com.Megan

Major depressive disorder is a common disorder that affects 5% to 13% of medical outpatients. The treatment of depression can be challenging, with many first-line options and even more second-line or next-step options. The STAR*D trial was the first of its kind developed to evaluate clinical strategies to improve outcomes for patients with treatment-resistant depression and determining the best next-step treatment option for patients who did not respond adequately to earlier treatment attempts. The trial included a widely representative group of outpatients so as to be applicable to the current practice in the treatment of depression. The trial consisted of 4 different treatment strategies with both switching and augmentation options. Patients were permitted to select treatment options at each of the levels that they themselves selected, creating a "realworld" setting in the trial. Patients were recommended to continue through each level until remission was reached. The study, though limited in size at each level, has provided much-needed information for the continued treatment of major depressive disorder.

Key Words: STAR*D • antidepressants • major depressive disorder • SSRIs

Journal of Pharmacy Practice, Vol. 19, No. 6, 353-360 (2006)
DOI: 10.1177/0897190007300736


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