July 7, 2006

Star-D Study Participants: What's Wrong With These People?

I don't even know what to make of this:


star-d participants 


4041 patients show up and consent to be in a massive antidepressant trial,  and almost 25% can't even score a HAM-D of 14? (7=complete cure.)  Who are these people?  What were they thinking?

star-d demographics1 


And then of the ones who actually stay to participate (N=2876), their average HAM-D is 21? For two years?


Star-d 1 Remission rates-- Celexa 



And Celexa cures a third of these patients?  Half of them in less than 6 weeks? After two years walking around HAM-D =21?  Cures?  Celexa?  40mg?  Hello? 


Remember, this is open label.  These people, who presumably have been in psychiatric treatment for a long time (mean length of illness 15 years), know that they are taking 40mg of Celexa.   Not a new experimental drug with a new mechanism of action.  Celexa.  1/3rd get cured.  After all this time.


BTW, the people who failed this Celexa study  get moved into Star-D II.  What is the relevance of this?  Well, in this study 63% were female, 75% were white, 40% were married, 87% were high school grads or greater, 56% had jobs.  It is the opposite of this demographic that is most likely not to have gotten better. 



Evaluation of Outcomes with Citalopram for Depression Using Measurement-Based Care in STAR*D.