Falling STAR*D?: It is common practice for psychiatrists to switch depressive patients between different antidepressants if their current drug does not evince a symptomatic response. Despite clinical wisdom supporting this, little empirical, controlled evidence exists to direct “switching” protocols (e.g. if a patient with Z characteristics is on drug X, is it usually better to switch to drug A, B, or C? Will switching help at all?) in the psychopharmacological treatment of depression. The NIMH-funded
STAR*D (Sequenced Alternatives to Relieve Depression) study aimed to address these questions of treatment direction in a very large (n>4000), “real-world” sample using a
multi-phase treatment plan with different drugs (and cognitive therapy) at every step to maximize chances of eventual remission. Overall, the NIMH reported that about
67% of patients eventually achieved remission,
with few differences in effectiveness between different types of treatment at each step. However, researchers and commentators have
raised concerns regarding inconsistent reporting of outcomes, after-the-fact changes in
study design and analysis, and other issues that may have inflated, partially invalidated, or misrepresented widely reported treatment outcomes. These inequities may also have implications for the secondary moderator analyses (i.e. does trait A predict switching to X or Y is better?) that were a major reason for the study.
[more inside]
posted by Keter
on Jan 14, 2012 -
12 comments
Nootropics ("smart" drugs) - all wish to be smarter, correct ? And - while exercise, nutrition, learning, travel, and social interaction (the last 3 via release of
neurotrophins) effectively do this, Nootropic drugs have been researched since the 1950's and have been shown to cause at least short term cognitive function enhancement. Piracetam, the first of this drugs,
shows promise in the treatment of Alzheimer's and Attention deficit Disorder. Alas, as with poor little
Algernon, the effect seems
temporary. Nootropics can be a little
difficult to acquire in the US.
Beer is not a nootropic, but sex on the other hand.....
posted by troutfishing
on Mar 5, 2004 -
20 comments