National Institute of Mental Health, Bethesda, MD 20892-9669, USA.
Psychiatr Serv. 2009 Nov;60(11):1466-7. doi: 10.1176/ps.2009.60.11.1466.
STAR*D (Sequenced Treatment Alternatives to Relieve Depression) continues to stimulate debate. The landmark trial demonstrated the feasibility of large-scale, community-based studies conducted without pharmaceutical company support. The results provided insight into nonresponse to initial treatment with selective serotonin reuptake inhibitors and alternatives for second- and third-line treatment options and suggested opportunities for personalized approaches to depression care. However, initial and one-year remission rates (28% and 70%, respectively) suggest that important goals for treatment of this disabling disease remain out of reach and that the bar for antidepressants has been set far too low.
STAR*D（序贯治疗选择缓解抑郁）继续引发争议。这项具有里程碑意义的试验证明了在没有制药公司支持的情况下进行大规模、基于社区的研究的可行性。研究结果深入了解了对选择性 5-羟色胺再摄取抑制剂初始治疗无反应的情况，以及二线和三线治疗选择的替代方案，并为抑郁症护理的个性化方法提供了机会。然而，初始和一年的缓解率（分别为 28%和 70%）表明，这种致残性疾病的治疗仍有重要目标遥不可及，抗抑郁药的标准定得太低了。
