STAR*D Trial Implications for Primary Care: What Family Doctors Need to Know
What does the STAR*D trial mean for primary care doctors?
STAR*D trial shows primary care doctors need systematic treatment algorithms and realistic expectations about antidepressant success rates. Only 37% of patients achieve remission with first antidepressant. Key implications:
- Lower expectations - first antidepressant works for only 1 in 3 patients
- Systematic approach - need structured algorithms for treatment failures
- Multiple attempts - most patients require 2-4 different treatments
- Measurement-based care - regular symptom tracking essential for success
A comprehensive review published in Primary Care Companion to the Journal of Clinical Psychiatry translates the landmark STAR*D trial findings for family physicians and internists. Since primary care practitioners diagnose and manage most individuals with depression, understanding these evidence-based treatment algorithms is crucial for improving outcomes in real-world clinical practice.