In the editorial it says this:

.."behavior therapy (the cognitive behavior therapy results have not yet been published)."

I would like to see those results. I believe that when discussing depression with a doctor the first thing the doc should do is an alternative, non-medicated approach first.
CBT, therapist, adjustment of lifestyle, which is sometimes what some people need before medicating something that could actually be a needed lifestyle change.
Small shifts, such as adding daily walking, boosting the immune system with whole foods, adding some B vitamins, and picking up a hobby along the way can often help reduce stress and depression without medication.
There are obviously severe depression patients that need medications, and I believe the changing of the meds too fast from one med to another without proper 'off med' time inbetween trials, is what the problem is.
Once I stopped giving in to the med offers from my doc, I started feeling better.
Oh I still take meds, but about 3 less than I did before.
Survival for me means trying my best to get decent sleep(and I mean 9 or more hours), getting outside every single day as well as not missing taking high B&C vitamins, cutting out an old habit of diet coke, and trying to monitor the admiration of wonderful wine bottle labels, which of course isn't an aisle I should really be lingering in too long. But that can go into the other category of taking time to stop and admire beauty throughout the day, or week, and not forgetting to go to art museums.
When the dark times hit, I ride em out the best I can, no antidepressants. Not easy, but better than suffering side effects of meds that don't work for me.

Hi, Philip. The third round STAR*D results are definitely major news. We clearly have to rethink antidepressant treatment strategy and we've got the study to prove it. If a patient has failed on two trials of antidepressants we're clearly looking at the falling over the edge of the cliff phenomenon where there is less than a one in five chance of success.

The AJP editorial was the usual blather, but the study findings were not. A lot of the study authors (maybe all of them) get very good money from the pharmaceuticals, yet they came out with what amounts to an anti-antidepressant study.

Until we get the breakthrough genetic and biological discoveries, we have to work with what we've got. This means being smarter with our current meds and talking therapies. That's what STAR*D was designed for. STAR*D should be publishing results soon on talking therapy.

The flaw in the STAR*D study is they probably didn't anticipate such dismal results in round three. There should have been an option to switch these patients onto bipolar meds to see what happens. Yes, I know you have you're skeptical, but we're not going to have any real answers unless we put this to the test.

The leading bipolar experts - Goodwin, Akiskal, Ghaemi, and others - are telling us that a lot of so-called unipolar depressions have characteristics of bipolar depressions. This suggests treating these people as if they had bipolar, with mood stabilizers. The catch is we're not very good at treating people with bipolar depressions. We have a long way to go.

I picked up a prescription for Celexa last spring after a 5 minute consultation with a nurse at University Health Services. I wasn't experiencing any depression, but rather a case of what students of yore called "senioritis"- post-graduation anxiety, insomnia, a stressful last semester courseload, ect.

I asked if the drug had any side effects and I was told that it did not, except "some increased anxiety in the beginning". For this I was prescribed Klonopin. I just removed myself from Klonopin a few weeks ago, and have gone through the most dysphoric, physically ill hell I could ever imagine. My psych nurse tech tried to convince me it was an episode of mania, but I know better. I know drugs, and I know withdrawal. When I took myself off Celexa following my first and only manic episode, I experienced a similar withdrawal, complete with the dreaded "brain zaps", nausea, headache, deep depression unlike anything I'd ever known, insomnia, difficulty concentrating, and general malaise.

These drugs are more often harder to stop than to start. And many people who are on them, and end up missing days and weeks of work or school, are never told that 70% of patients will NOT see a remission of their depression in taking them. Nor will they be informed of the pain and discomfort of withdrawal, which often can mimic an organic depressive or manic episode (not to mention that the drugs themselves can induce them). I certainly never was told, until it was too late.