Effects of Race and Ethnicity on Depression Treatment Outcomes: The CO-MED Trial
by Ira M. Lesser, M.D., Sidney Zisook, M.D., Bradley N. Gaynes, M.D., M.P.H., Stephen R. Wisniewski, Ph.D., James F. Luther, M.A., Maurizio Fava, M.D., Ahsan Khan, M.D., Patrick McGrath, M.D., Diane Warden, Ph.D., A. John Rush, M.D. and Madhukar Trivedi, M.D.
Psychiatric Services 2011 62:1167-1179.
Methods: This single-blind, seven-month prospective, randomized trial enrolled 352 non-Hispanic white [59%], 169 black [28%], and 79 white Hispanic [13%] participants from six primary and nine psychiatric care U.S. sites. Patients had nonpsychotic chronic or recurrent major depressive disorder [or both] of at least moderate severity. Escitalopram plus placebo, bupropion sustained-release plus escitalopram, or venlafaxine extended-release plus mirtazapine were delivered according to measurement-based care. The primary outcome was remission [last two consecutive 16-item Quick Inventory of Depressive Symptomatology-Self-Report ratings <8 and <6]; secondary outcomes included side effects, adverse events, quality of life, function, and attrition.
Conclusions: Despite differences in sociodemographic characteristics and comorbidities, when measurement-based care was used, members of different minority groups had similar outcomes when treated with one antidepressant or a combination of two antidepressants. Black participants had the highest attrition rate, an important issue to address in clinical care.
…The authors also acknowledge the editorial support of Jon Kilner, M.S., M.A.
In the last post, I was reminded of the glut of STAR*D articles that just kept keep coming. One might have thought they would go light on a study so absolutely negative as CO-MED, but they’ve squeezed out a total of four extra meaningless papers beyond the negative study report so far:
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Combined Antidepressant Strategies Are Not More Effective Than Vigorous Escitalopram Monotherapy: Results of the CO-MED Study.
by Thase ME.
Current Psychiatry Reports. 2011 September 29. -
Baseline depression severity as a predictor of single and combination antidepressant treatment outcome: Results from the CO-MED trial.
by Friedman ES, Davis LL, Zisook S, Wisniewski SR, Trivedi MH, Fava M, Rush AJ; CO-MED Study Team
European Neuropsychopharmacology. 2011 September 13. -
Randomized comparison of selective serotonin reuptake inhibitor (escitalopram) monotherapy and antidepressant combination pharmacotherapy for major depressive disorder with melancholic features: a CO-MED report.
by Bobo WV, Chen H, Trivedi MH, Stewart JW, Nierenberg AA, Fava M, Kurian BT, Warden D, Morris DW, Luther JF, Husain MM, Cook IA, Lesser IM, Kornstein SG, Wisniewski SR, Rush AJ, Shelton RC.
Journal of Affective Disorders. 2011 133(3):467-76. -
Combining medications to enhance depression outcomes (CO-MED): acute and long-term outcomes of a single-blind randomized study.
by Rush AJ, Trivedi MH, Stewart JW, Nierenberg AA, Fava M, Kurian BT, Warden D, Morris DW, Luther JF, Husain MM, Cook IA, Shelton RC, Lesser IM, Kornstein SG, Wisniewski SR.
American Journal of Psychiatry. 2011 168(7):689-701.
What is the point of doing this kind of paper churning? It seems like they’d be embarrassed…
The point of paper churning is that it gives you references to cite. And it also gives you a lot more visibility in a pub med search.
People get a lot of citations behind their names, which helps with tenure and money. It gives pharma specific refs to cite as evidence when they make claims (that used to be one of the biggest reasons).
It also used to be used as a “reward”–at one point, all the docs phase IV trials were being included as authors–it was one of the inducements to get them to take part.
Not to go on, but think about it. If 5 people publish 3 things apiece, suddenly you’ve got “A great deal of attention has been focused in recent years on the potential for X in the treatment of Y” then 15 refs. It really makes it look legit–like there really is a lot of attention. When in fact it could be one pub plan.