When Your Antidepressant Fails

We can look forward to learning much more about switching antidepressants when the National Institute of Mental Health's STAR*D (Sequenced Treatment Alternatives to Relieve Depression) study involving 4,000 patients begins announcing results sometime over the next five years. In the initial phase, all of the patients will be given Celexa, of which half are expected to fail. Steps two, three, and four involve switching to different antidepressants or combinations (including combining an antidepressant with talking therapy). The nonresponders who are left will be allowed to pursue further options with their individual physicians.

Even the champions of drug therapy acknowledge that our first antidepressant basically amounts to scratch lotto in pill form. But our next attempt or the attempt after, like reverse Russian roulette, may yield the bullet, maybe not the magic bullet we are all so desperately seeking, but something reasonably serviceable that gives us a fighting chance of recovery.

For three free issues of my depression and bipolar newsletter, mailto:jmcmanamy@snet.net and put "Newsletter" in the subject line and your email in the body.

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