There are many landmark psychiatric studies in psychiatry that clinicians should be aware of. Key studies are listed below (work in progress).
STAR*D (Sequenced Treatment Alternatives to Relieve Depression) was an NIMH study that compared the effectiveness of various antidepressants. STAR*D was actually a multi-level study, with 4 levels. In Level 1 of STAR*D, patients with major depressive disorder were treated on citalopram. Remission and response rates, treatment length, and features associated with remission were investigated. comorbidities.
Design | Open-label, pragmatic |
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Year | 2006 |
Sample size | N = 2876 |
Population | Ages 18-75, non-psychotic major depressive disorder (Hamilton Depression Rating Scale [HAM-D] ≥14) |
Sites/Locations | Clinical sites across the United States providing primary or psychiatric care. |
Allocation | All patients received citalopram (open label), with no placebo control |
Follow up | Up to 14 weeks |
Primary outcome | Remission (HAM-D ≤7) |
Secondary outcomes | Remission (Quick Inventory of Depressive Symptomatology, Self-Report [QIDS-SR]≤5), or response (QIDS-SR reduction of ≥50% in baseline score). |
Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) was an NIMH study designed to compare the effectiveness of antipsychotic drugs in adults with schizophrenia in the United States.
Design | Randomized Controlled Trial |
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Year | 2005 |
Sample size | N=1,493 |
Population | Adults with schizophrenia, ages 18-65 |
Sites/Locations | 57 sites in the United States |
Allocation | Participants were randomly assigned to receive 1 of 5 antipsychotics: olanzapine, perphenazine, quetiapine, risperidone, and ziprasidone. |
Follow up | Patients were followed for 18 months or until treatment was discontinued |
Primary outcome | Discontinuation of treatment for any cause |
Secondary outcomes | Inefficacy, intolerability due to weight gain, extrapyramidal side effects, sedation, Positive and Negative Syndrome Scale (PANSS), Clinical Global Impressions (CGI) Scale. |
The National Institute of Mental Health (NIMH) Treatment of Depression Collaborative Research Program (TDCRP) was a multisite RCT that compared medication, CBT, IPT, pharmacotherapy with clinical management, and clinical management alone. High baseline depression severity in patients showed that those receiving medication did best followed by patients receiving IPT which outperformed CBT in this study