Should findings in the STAR*D study change the way people approach the treatment of depression?
The findings from the STAR*D study illustrate that depression is a serious illness for which current treatments, if provided in a rigorous, iterative, step-by-step way, can get a majority of people better. The findings also illustrate that our first-line treatments are imperfect and that in current practice, standard remedies typically used as the third-, fourth-, and fifth-line treatments require a level of training and expertise that may be beyond many practitioners’ means. Our house staff needs to know how to prescribe a TCA, lithium, and a monoamine oxidase inhibitor before they leave training because these three old-guard treatments underperformed in the STAR*D study. They were not used as well as they should have been.
