March 22, 2006 Don’t give up hope, a new study suggests to people suffering with depression.
It may take 14 weeks and a change of medication, but people with major depression now have a 5050 chance of getting better and getting well.
What about the 50% of people who don’t get well? There’s still hope they’ll get well, too.
The findings come from the second phase of the STARD trial. It’s an ambitious, ongoing study funded by the National Institute of Mental Health. The goal: to see, in a stepbystep fashion, just what it takes to put major depression into full remission.

Phase I of the trial

Phase I of the trial
showed that he antidepressant Celexa helps nearly a third of patients get well. Now phase II of the trial shows that switching drugs or adding a new drug makes a third of the remaining patients well.
That adds up to about half of the patients in the study, says study coleader A. John Rush, MD, professor and vice chairman for research in psychiatry at the University of Texas Southwestern Medical Center at Dallas.
“The big message is that symptoms can be eliminated in over 50% of people who receive two treatment steps,” Rush said at a news conference. “For patients, it is important not to give up if the first treatment does not work fully, or if it causes side effects. Most patients should expect at least two treatment attempts to become asymptomatic.”
Results of the $35 million study funded by the NIMH and not by drug companies appear in two papers in the March 23 issue of The New England Journal of Medicine.
Depression: An Emotional Cancer
The size of this government effort to find effective depression treatments testifies to the severity of the illness. Depression is often seen “as a weakness, if not a vice,” notes an NEJM editorial by David R. Rubinow, MD, chairman of psychiatry at the University of North Carolina at Chapel Hill.
“The STARD trial is attempting to discover the best way of treating a destructive, malignant, and lifethreatening illness,” Rubinow tells WebMD. “Anything that can help reduce the astronomical burden of depression is well worth the investment of public resources.”
NIMH director Thomas Insel, MD, notes that depression costs the U.S. economy $83 billion each year. Nearly 7% of U.S. adults 15 million Americans suffer depression each year. Suicide will claim 4% of these lives.
“Depression is disease defined by emotional pain. It is a total collapse of vitality, an emotional cancer that takes away any hope of joy or feeling,” Insel said at a news conference. “Depression precludes the very effort needed for recovery. Often with major depressive disorder, just getting out of bed to go to work or school becomes an insurmountable challenge.”

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