Now Where Did I Put My Happy Pills?

For the past six years, A. John Rush of the University of Texas Southwestern Medical Center has been leading a federal study on depression; it's been released in bits and pieces over the past few months, with some findings being published as recently as March. But Rush, who's the vice chairman of clinical sciences at UT Southwestern, and his group yesterday released the final stage of their $35-million research project, and they've made what appears to be a very simple discovery: If you're taking drug for your depression and they don't work, keep trying. And try again. Chances are something'll stick.

The results of this phase of the study--called the Sequenced Treatment Alternatives to Relieve Depression (or STAR*D) study--were reported yesterday in the American Journal of Psychiatry; only the abstract is available to non-subscribers. But an editorial in the journal explains that anyone who wanted to be part of the study could be part of the study, which was funded by the National Institute of Mental Health. Only "psychotic and bipolar patients were excluded," the Journal reports, while "most other psychiatric disorders were allowed," as were patients "with recent active substance abuse." Which, ya know, does kinda make you wonder how reliable the info obtained was.

Turns out, the only problem with trying several different medications to treat depression is the more drugs you try, the more likely you are to suffer a relapse. That's what Rush tells USA Today today, which reports:

Only 37% went into remission after trying the first drug, says study leader A. John Rush... As each new treatment was tried, it worked on fewer and fewer patients. About a third did not go into remission, despite up to four rounds of treatments. And many dropped out, perhaps because they were discouraged or disliked the side effects. "But persistence pays off," Rush says. "For those who hang in there, recovery is possible."

But there's a more troubling sidebar to the story here: In its front-page story on the study, The Dallas Morning News reports that "the article also lists that almost all the scientists on the study, including Dr. Rush and two other UT Southwestern researchers, have financial ties to pharmaceutical or medical care companies." So naturally they want you to keep trying drugs, right? Right. That's depressing. --Robert Wilonsky

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