Clinical Psychiatry News - Low remission seen with third antidepressant: STAR*D trial calls into question the practice of switching classes when an SSRI doesn’t help.(selective serotonin…

Less than 20% of patients switched to a third consecutive antidepressant for major depressive disorder achieved remission in a study published by the STAR*D trial investigators.

They reported low remission rates for mirtazapine and nortriptyline, the two medications compared in the third phase of the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial (Am. J. Psychiatry 2006;163:1161-72).

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Only 12.3% of 114 patients who switched to mirtazapine reached the trial’s definition of remission: a score of 7 or less on the 17-item Hamilton Rating Scale for Depression …

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