Talk:STAR-D

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NEJM publication

Published earlier in the same year, it highlights the second step.[1] Would be reasonable to try to pull into the major points section and also to look at the letters/editorial.

tim's original description

Participants progressed through 4 different levels of treatment through 4 or 5 steps (depending on if they underwent CBT as a component of level 2).

Treatment by levels

Level 1
Citalopram (n=3,671)
Level 2

Patients could decline randomization to any of the following

Switch therapy:
Bupropion SR (n=239)
Sertraline (n=238)
Venlafaxine XR (n=250)
Augmentation therapy:
Citalopram + bupropion SR (n=279)
Citalopram + buspirone (n=286)
CBT + citalopram (n=85)
CBT therapy:

Referred to as CBT in levels 2A, 3, and 4

CBT alone (n=61)
CBT + citalopram (n=85)
Level 2A

Only those from CBT

Bupriopion SR (n=15)
Venlafaxine SR (n=16)
Level 3

Patients could decline randomization to any of the following

Switch therapy:
Nortriptyline (n=116, prior CBT n=5)
Mirtazapine (n=110, prior CBT n=4)
Augmentation therapy:
Addition of lithium (n=63, prior CBT n=6)
Addition of T3 (n=70, prior CBT n=3)
Level 4
Tranylcypromine (n=55, prior CBT n=3)
Venlafaxine XR + mirtazapine (n=50, prior CBT n=1)

Treatment by steps

Step 1 (n=3,671)
Citalopram
Step 2 (n=1,439)
Switch therapy:
Bupropion SR (n=239)
CBT (n=62)
Sertraline (n=238)
Venlafaxine XR (n=250)
Augmentation therapy:
Bupropion (n=279)
Buspirone (n=286)
CBT (n=85)
Step 3 (n=390)
Level 2A, treated with prior CBT:
Bupropion (n=15)
Venlafaxine XR (n=16)
Level 3:
Switch therapy:
Mirtazapine (n=110)
Nortriptyline (n=116)
Augmentation therapy:
Lithium (n=63; plus bupropion n=8, plus citalopram n=37, plus sertraline n=10, plus venlafaxine XR n=15)
T3 (n=70; plus bupropion SR n=8, plus citalopram n=37, plus sertraline n=10, plus venlafaxine XR n=15)
Step 4 (n=123)
Level 3 (n=18; see details above)
Tranylcypromine (n=55)
Venlafaxine XR/mirtazapine (n=50)