Posted by dcruik518 on August 3, 2008, at 18:38:54
The latest issue of the Harvard Mental Health Letter lays out an interesting and successful protocol for finding the right depression medication(s). It's called STAR-D and it stands for Sequenced Treatment Alternatives to Relieve Depression. The study found good results. Each trial was given 8wks to work, as they found one of the most common reasons for treatment failure was early termination.
Level 1: Celexa 33% remission rate
Level 2. Switch to Zoloft, Effexor, or augment Celexa with Wellbutrin or Buspar.
57% remission rateLevel 3. Stop current meds. Switch to Remeron or Nortriptyline. Augment current therapy with lithium or T3 thyroid hormone (Cytomel).
63% remission rate.(Study also found new generation antipsychotics are also effective augmentation agents: Risperdal, Zyprexa, Geodon, and Seqoquel act synergistically with AD's in some patients.) For some reason Abilify not mentioned.
Level 4. Stop current therapy and switch to Parnate, Nardil, or Remeron + Effexor.
67% Remission rate.
This is the largest study conducted of it's kind, enrolling 3671 patients at 41 sites nationwide.
Other agents: investigators are also researching testosterone, estrogen, SAMe, Omega 3 fatty acids, and variety of anticonvulsants.Questions? let me know, there's more to article.
~DRC
poster:dcruik518
thread:843960
URL: http://www.dr-bob.org/babble/20080727/msgs/843960.html