Update on the Star*D Report


Two months ago, I wrote a post about a New Yorker article that reported that 67% of the depressed patients in the STAR*D trial “recovered.” As I noted in that post, the 67% figure was a highly exaggerated number. Only 51% of the 3,671 patients who entered the trial ever remitted, even for a short period. Furthermore, only about 20% of the patients remitted and then reported to STAR*D investigators, at some point during a 12-month follow-up period, that they were still doing well.

But this left an obvious question, one that I hadn’t been able to find an answer to in the published STAR*D reports. How many of the 3,671 people who entered the trial remitted and then stayed well and in the trial throughout the entire 12-month follow-up? That number would provide a documented long-term recovery rate for patients in the trial.

A few days ago, Allan Leventhal sent me a 2009 article he coauthored with David Antonuccio, and in it, they successfully identified this number (finding it in a confusing graphic I hadn’t been able to decipher.) In their computations, they relied on STAR*D reports that told of 4,041 initial participants (3,671 was the number of “enrolled” patients counted in the analysis of drug-remission rates), and then they came to this bottom-line conclusion about the documented long-term recovery rate:

“Although the study’s reports make no mention of this outcome, their data show that after a year of continuation treatment following remission, of the 4,041 patients who entered the program only 108 (3%) had a sustained remission — all the other patients either dropped out or relapsed. Yet STAR*D’s authors and the NIMH have publicized the study as showing a 67% success rate for antidepressants.”

Such is the gap, rather considerable in size, between what the New Yorker reported as the recovery rate, and the actual numbers.


Wednesday, May 19, 2010


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.