Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report.
by Rush AJ, Trivedi MH, Wisniewski SR, Nierenberg AA, Stewart JW, Warden D, Niederehe G, Thase ME, Lavori PW, Lebowitz BD, McGrath PJ, Rosenbaum JF, Sackeim HA, Kupfer DJ, Luther J, Fava M.
Am J Psychiatry. 2006 163:1905-1917.
OBJECTIVE: This report describes the participants and compares the acute and longer-term treatment outcomes associated with each of four successive steps in the Sequenced Treatment Alternatives to Relieve Depression [STAR*D] trial.CONCLUSIONS: When more treatment steps are required, lower acute remission rates [especially in the third and fourth treatment steps] and higher relapse rates during the follow-up phase are to be expected. Studies to identify the best multistep treatment sequences for individual patients and the development of more broadly effective treatments are needed.
But there was something else. This study that couldn’t bring off collecting or publishing its own primary data continues to be a well-spring for an endless string of publications. PubMed lists 142 articles with STAR*D in the title, but there are many where that phrase isn’t in the title [below]. They’ve had the same editorial·assistant/ghost·writer throughout – Jon Kilner, a science fiction author in Pittsburgh, and many of the papers have the original authors in some reshuffled order.
Increase in Work Productivity of Depressed Individuals With Improvement in Depressive Symptom Severity.
by Trivedi MH, Morris DW, Wisniewski SR, Lesser I, Nierenberg AA, Daly E, Kurian BT, Gaynes BN, Balasubramani GK, and Rush AJ.
American Journal of Psychiatry. 2013 Apr 5.
[Epub ahead of print]
OBJECTIVE: The authors sought to identify baseline clinical and sociodemographic characteristics associated with work productivity in depressed outpatients and to assess the effect of treatment on work productivity.METHOD: Employed depressed outpatients 18-75 years old who completed the Work Productivity and Activity Impairment scale [N=1,928] were treated with citalopram [20-40 mg/day] in the Sequenced Treatment Alternatives to Relieve Depression study. For patients who did not remit after an initial adequate antidepressant trial [level 1], either a switch to sertraline, sustained-release bupropion, or extended-release venlafaxine or an augmentation with sustained-release bupropion or buspirone was provided [level 2]. Participants’ clinical and demographic characteristics and treatment outcomes were analyzed for associations with baseline work productivity and change in productivity over time.RESULTS: Education, baseline depression severity, and melancholic, atypical, and recurrent depression subtypes were all independently associated with lower benefit to work productivity domains. During level 1 treatment, work productivity in several domains improved with reductions in depressive symptom severity. However, these findings did not hold true for level 2 outcomes; there was no significant association between treatment response and reduction in work impairment. Results were largely confirmed when multiple imputations were employed to address missing data. During this additional analysis, an association was also observed between greater impairment in work productivity and higher levels of anxious depression.CONCLUSIONS: Patients with clinically significant reductions in symptom severity during initial treatment were more likely than nonresponders to experience significant improvements in work productivity. In contrast, patients who achieved symptom remission in second-step treatment continued to have impairment at work. Patients who have demonstrated some degree of treatment resistance are more prone to persistent impairment in occupational productivity, implying a need for additional, possibly novel, treatments.
2006: "Dr. Trivedi has served as an advisor, consultant, or speaker for or received research support from Abbott Laboratories, Inc.; Akzo [Organon Pharmaceuticals]; Bayer; Bristol-Myers Squibb Company; Cephalon, Inc.; Corcept Therapeutics, Inc.; Cyberonics, Inc.; Eli Lilly; Forest Pharmaceuticals; GlaxoSmithKline; Janssen Pharmaceutica; Johnson & Johnson PRD; Meade Johnson; the National Institute of Mental Health; the National Alliance for Research in Schizophrenia and Depression; Novartis; Parke-Davis Pharmaceuticals, Inc.; Pfizer Inc; Pharmacia & Upjohn; Predix Pharmaceuticals; Sepracor; Solvay Pharmaceuticals, Inc.; and Wyeth-Ayerst Laboratories."
2013: "Dr. Trivedi has received research support from or served as an adviser, consultant, or speaker for Abbott Laboratories, Abdi Ibrahim, Agency for Healthcare Research and Quality, Akzo [Organon Pharmaceuticals], Alkermes, AstraZeneca, Axon Advisors, Bristol-Myers Squibb, Cephalon, Corcept Therapeutics, Cyberonics, Eli Lilly, Evotec, Fabre Kramer Pharmaceuticals, Forest Pharmaceuticals, Glaxo-SmithKline, Janssen Pharmaceutica Products, Johnson & Johnson PRD, Libby, Lundbeck, Mead Johnson, MedAvante, Medtronic, Merck, National Institute on Drug Abuse, NARSAD, Naurex, Neuronetics, NIMH, Novartis, Otsuka Pharmaceuticals, Pamlab, Parke-Davis Phar-maceuticals, Pfizer, PgxHealth, Pharmacia & Upjohn, Predix Pharmaceuticals [Epix], Rexahn Pharmaceuticals, Roche Products, Sepracor, Shire Development, Sierra, SK Life and Science, Solvay Pharmaceuticals, Takeda, Transcept, VantagePoint, and Wyeth-Ayerst Laboratories."