More on The STAR-D Study

As I mentioned previously, important results from the STAR-D study of depression and treatments with anti-depressants came out this week in the New England Journal of Medicine. Most of the press bought the spin that all these studies meant was that patients just need to keep switching meds until they find the magic anti-depressant. That assessment is bullshit and I am not sure who was spinning it for reporters out there in cubicle land.

Based upon actually reading the studies (this is something more reporters need to do and thanks to NEJM for giving me the .pdfs), it's clear that the two studies paint a very gloomy picture of the state of the art in treating depression. What's more, if you understand the real world patients live in, then the studies are even more damning. Accompanying two studies in NEJM was an editorial by David Rubinow, a psych researcher at UNC-Chapel Hill. Rubinow partially agrees with my assessment of just how crappy things are.

He notes that the first end of the multi-part STAR-D study showed that patients taking Celexa, the main med used in the study as a proxy for the major SSRIs, only experienced remission of symptoms 30 percent of the time. Then he moves to the current results: "The results suggest that at least half of the patients with depression do not have a remission."

Where have we heard that before? The bad news is compeltely lost on the folks at NAMI National who declared that the results are "hope." Kind of an odd statement to make in response to a study that both confirms that psych meds work about half the time and the full remission happens even less. An odd statemnt, too, in light of the fact that these meds aren't just taken by people with depression but by millions of bipolars. But, whatever. I guess that's why I am not in the advocacy business, where you apparently have to take money from pharma companies like NAMI does.

I'll take up the two sets of results in a following post.