The STAR*D is a pragmatic clinical trial that showed lower remission rate and higher relapse rate when more strategies were used.[1]

Assess clinical improvement in symptoms related to depression, anxiety and sleep, based on the number of strategies used.

Descriptive, non-interventional, prospective study including outpatients diagnosed with Major Depressive Disorder (MDD) with sub-optimal response to standard antidepressants. In those patients a change on the therapeutic strategy (switch of antidepressant, combination of antidepressants, augmentation or a combination of previous strategies) had to be considered necessary. Follow-up period was 22–26 weeks.

364 patients were included by 58 psychiatrists, 336 were analyzed (92.3%) and 315 (86.5%) completed the follow-up.

[Difference last visit vs. basal]

p < 0.0001 in all measures

The more changes on strategies used the less improvement on clinical symptoms and remission rates.

This study has been sponsored by AstraZeneca Farmaceutica Spain, SA.