The STAR*D Trial: First Results

Topics: Antidepressants

When National Public Radio’s Science Friday devotes most of a program to a psychiatric study, it must be newsworthy. The STAR*D study got this special treatment recently, with Ira Flato interviewing John Rush about the ins and outs of the NIMH-funded project. What is the STAR*D study? Are the initial results as earth-shaking as promised? And should

How to Bring STAR*D Techniques into Your Practice

Topics: Antidepressants | Practice Tools and Tips

Because the first results from STAR*D make antidepressants look less powerful than we might have hoped, researchers have emphasized another aspect of the study – namely, that it represents a system that allows us to bring research techniques into our practices. And while some statements made in support of the STAR*D methodology come across as pretty g

Interpreting the STAR*D Trial

Topics: Antidepressants

Vagus Nerve Stimulation: Is the Evidence Convincing?

Topics: Antidepressants | Brain Devices

The Cyberonics brochures have been leaping into your mailboxes. “A new strategy for the challenge of treatment-resistant depression,” they proclaim. Vagus nerve stimulation (VNS) is certainly new—but is it effective? It took the FDA a long time to make up its mind, but eventually it approved the treatment in May 2005. (For more details on why t

FDA Approval of VNS: The All-Too-Human Side of a Bureaucracy

Topics: Antidepressants | Brain Devices

First they said yes to VNS, then no, then yes. And now they’re trying desperately to explain their final answer. On June 15, 2004, the Neurological Devices Panel of the Medical Devices Advisory Committee voted by a 5-2 margin to recommend VNS for approval for TRD. We encourage our readers to go to the transcript of this meeting, at http://www.fd

VNS: Some Practical Information

Topics: Antidepressants | Brain Devices | Practice Tools and Tips

If, after reviewing our admittedly lukewarm evaluation of the VNS data, you decide that you want to offer it to your patients, here’s some useful information. The procedure is being done primarily at major tertiary medical centers now, but this will change over time. Currently, insurance plans pay for the procedure for depression only on a case-by-

Choosing Antidepressants

Topics: Antidepressants

Michael Posternak, MD Assistant Clinical Professor of Psychiatry, Brown University School of Medicine Dr. Posternak has disclosed that he has no significant relationships with or financial interests in any commercial companies pertaining to this educational activity. The author has disclosed that triidothyronine and methylphenidate have not been a