Sequenced Treatment Alternatives to Relieve Depression (STAR*D): Part 2: Study Outcomes

Howland, Robert H.

doi:10.3928/02793695-20081001-05

Cited by 115Treatment of Major DepressionMental Health Treatment and AccessAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Sequenced Treatment Alternatives to Relieve Depression (STAR*D): Part 2: Study Outcomes

Howland, Robert H.·2008·Journal of Psychosocial Nursing and Mental Health Services

DOI 10.3928/02793695-20081001-05

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Abstract

This article reviews the main outcome findings from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. The study compared the efficacy and tolerability of a range of antidepressant therapies through four sequential levels of treatment with the goal of achieving remission. Remission rates based on the primary outcome measure (Hamilton Rating Scale for Depression) were 28% (Level 1 citalopram), 17% to 30% (Level 2 treatments), 12% to 25% (Level 3 treatments), and 7% to 14% (Level 4 treatments). For patients not responding adequately to an initial trial of citalopram, subsequent treatment strategies may be effective. When more treatment steps are required, however, lower acute remission rates, greater degrees of treatment intolerance, and higher relapse rates during follow up are seen. There were few differences among treatments within each level related to efficacy or tolerability, although patients had clear preferences for or against certain treatments.

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The Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study revealed that 50% to 66% of depression patients did not recover fully on antidepressant medications.
“while a larger study, the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, revealed that 50% to 66% of depression patients did not recover fully on antidepressant medications.33”
From Study protocol on the efficacy of exergames-acceptance and commitment therapy program for the treatment of major depressive disorder: Comparison with acceptance and commitment therapy alone and treatment-as-usual in a multicentre randomised controlled trial (2024) · cites this paper as [33]

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Authors: Howland, R. H.
Affiliations: University of Pittsburgh (US)
Corresponding author: Howland, Robert H.
ORCID: Howland, Robert H.
Venue: Journal of Psychosocial Nursing and Mental Health Services
Publisher: SLACK, Inc.
Published: 2008-10
Volume: 46
Issue: 10
Pages: 21-24
ISSN: 0279-3695 (ISSN-L)
1938-2413
DOI: 10.3928/02793695-20081001-05
OpenAlex: W146502225
Cited by: 115
References: 15
Citations by year: 2026: 5 · 2025: 14 · 2024: 9 · 2023: 12 · 2022: 9 · 2021: 7 · 2020: 7 · 2019: 9 · 2018: 7 · 2017: 7 · 2016: 3 · 2015: 10 · 2014: 3 · 2013: 2 · 2012: 3
FWCI: 1.87
Type: journal article
Language: en
Open access: closed
Locations: Journal of Psychosocial Nursing and Mental Health Services (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: depression, antidepressants, STAR*D, sequential therapy, citalopram, remission, treatment response, treatment intolerance, relapse, patient preferences, antidepressant efficacy
MeSH terms: Antidepressive Agents, Combined Modality Therapy, Depressive Disorder, Humans, Remission Induction, Research Design, Randomized Controlled Trials as Topic, Treatment Outcome

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Sequenced Treatment Alternatives to Relieve Depression (STAR*D): Part 2: Study Outcomes

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