Project Summary

Jonathan W. Stewart, M.D. (Independent Investigator 2001) of New York State Psychiatric Institute, is studying people with refractory depression (treatment resistant depression).  He mentions a new treatment assessment launched by NIMH, STAR*D (Sequenced Alternatives to Relieve Depression), which is essentially an assessment procedure for developing a treatment plan for people who have been unsuccessful with different measures to help their depression.  Dr. Stewart believes STAR*D equates all depression as the same, and does not define treatment based on different types of depression.  As different depressive subtypes respond differently to different antidepressant medications, Dr. Stewart will study patients who have had at least three prior unsuccessful treatments and will offer medications appropriate to the relevant clinical features (i.e., melancholic features will receive a tricyclic plus lithium and patients with atypical features will be treated with a monoamine oxidase inhibitor).  Those patients with neither subtype will receive both treatments alternately.  This will provide pilot work for a larger study, and Dr. Stewart will then use the results to make application to NIMH to continue the work.

Program Area: MOOD DISORDERS

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