BMJ Open July 2023 PMID 37491091

What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapies in real-world depressed patients? A reanalysis of the STAR*D study's patient-level data with fidelity to the original research protocol.

H Edmund Pigott, Thomas Kim, Colin Xu, Irving Kirsch, Jay Amsterdam

Mentions

66
Peak: 24 in Aug 2023
across 6 sources since Jul 2023

Extended reach

161,463
potential audience

Total likes

225

Video views

297

Mentions per month

Jul 2023 – Aug 2025

Where it's discussed

  • X / Twitter55 posts
  • Reddit4 posts
  • YouTube2 videos
  • News2 articles
  • Blogs2 articles
  • LinkedIn1 posts

AI synopsis

What people are saying

Several discussions criticize the original STAR*D study, highlighting that only 35% remission was found with the new analysis compared to the previously claimed higher rates, using phrases like 'stinks' and 'did not follow its protocols' to express dissatisfaction. Others show moderation with mentions of reanalysis and methodological critiques, indicating a mix of skepticism and engagement that could influence how future depression treatments are interpreted and applied.

AgreementLow agreement

Most discussions express skepticism or criticism about the original study’s findings and protocols, indicating disagreement.

InterestModerate interest

Participants show curiosity about the reanalysis and its implications, reflecting moderate interest.

EngagementModerate engagement

Posts delve into methodological issues and implications of the new analysis, showing some thoughtful engagement.

ImpactModerate impact

The conversations challenge prior beliefs about treatment success rates, suggesting a moderate potential impact on clinical perspectives.

Abstract in brief

  • The reanalysis of the STARD study focuses on how effective and how much improvement depressed patients experienced after up to four rounds of antidepressant treatments, highlighting real-world clinical settings with diverse patient groups.
  • The study involved patients seeking care (not just research participants), many with other medical or psychiatric conditions, and tested multiple antidepressants when initial treatment with citalopram failed, aiming to reflect typical clinical practice.
  • The original STARD study defined remission and response based on standardized scales but was criticized for possibly overstating success rates because it used nonblinded assessments instead of the protocol-approved blinded measures, potentially inflating outcomes.]

Top posts

Most liked on X and Bluesky
Chris Aiken, MD
@chrisaikenmd · X

Was STAR*D wrong? New analysis finds #depression trial did not follow its protocols. With a more conservative approach, they estimated only 35% remitted after at <=4 treatment attempts, much less than the original 67% https://t.co/FyTcLNWJRH #psychiatry #clinicaltrials https://t.co/dR0aiBKUTv

Aug 11, 2023 · 73 likes · 16 shares · 8,481 followers View post →
Luke Nakaji/中島 振一郎@バルサと島巡りと猫と精神医療
@Luke_629 · X

What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapies in real-world depressed patients? A reanalysis of the STAR*D study's patient-level data with fidelity to the original research https://t.co/obJ7R6ur13

Aug 11, 2023 · 46 likes · 9 shares · 2,279 followers View post →
Carlat Psychiatry
@CarlatPsych · X

Was STAR*D wrong? New analysis finds #depression trial did not follow its protocols. With a more conservative approach, they estimated 35% remitted after at <=4 treatment attempts, much less than the original 67% -@ChrisAikenMD https://t.co/sV4wrOmx6J #psychiatry #clinicaltrials https://t.co/oISGGxq5hZ

Aug 11, 2023 · 35 likes · 9 shares · 8,078 followers View post →
Melissa Raven
@psychepi · X

What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapies in real-world depressed patients? A reanalysis of the STAR*D study ... with fidelity to the original research … @BMJ_Open https://t.co/VULGhSJBio

Jul 29, 2023 · 34 likes · 21 shares · 2,458 followers View post →
Nicolas Badre
@BadreNicolas · X

• 1977 Psychiatry: Pretest. Nelson, J. • Original STAR*D (Rush et al. 2006): https://t.co/rUWEFaf5ir… • Re-analysis (Pigott et al. 2023): https://t.co/g6X1VP29mR… https://t.co/rqhHBLg0N8

Jun 4, 2025 · 9 likes · 1 share · 2,667 followers View post →
Nicolas Badre
@BadreNicolas · X

List of pharma companies mentioned in the disclosure of STAR*D (picture below). • Original STAR*D (Rush et al. 2006): https://t.co/rUWEFaf5ir • Re-analysis (Pigott et al. 2023): https://t.co/g6X1VP29mR • Recent textbook mention of STAR*D Tasman (2024, p1844) • 2006 STAR*D https://t.co/iktyMGHyUl

Apr 10, 2025 · 6 likes · 1 share · 2,667 followers View post →

All mentions

Alpha 9x
@Potsherd24 · X

RT @BadreNicolas: • 1977 Psychiatry: Pretest. Nelson, J. • Original STAR*D (Rush et al. 2006): https://t.co/rUWEFaf5ir… • Re-analysis (Pig…

Jun 5, 2025 · 1 share · 1,308 followers View post →
Nicolas Badre
@BadreNicolas · X

• 1977 Psychiatry: Pretest. Nelson, J. • Original STAR*D (Rush et al. 2006): https://t.co/rUWEFaf5ir… • Re-analysis (Pigott et al. 2023): https://t.co/g6X1VP29mR… https://t.co/rqhHBLg0N8

Jun 4, 2025 · 9 likes · 1 share · 2,667 followers View post →
Frederico Magalhaes
@fredemag · X

RT @BadreNicolas: List of pharma companies mentioned in the disclosure of STAR*D (picture below). • Original STAR*D (Rush et al. 2006): ht…

Apr 11, 2025 · 1 share · 945 followers View post →
Nicolas Badre
@BadreNicolas · X

List of pharma companies mentioned in the disclosure of STAR*D (picture below). • Original STAR*D (Rush et al. 2006): https://t.co/rUWEFaf5ir • Re-analysis (Pigott et al. 2023): https://t.co/g6X1VP29mR • Recent textbook mention of STAR*D Tasman (2024, p1844) • 2006 STAR*D https://t.co/iktyMGHyUl

Apr 10, 2025 · 6 likes · 1 share · 2,667 followers View post →
Kindly #deprescribe -- taper psychiatric drugs
@Altostrata · X

RT @KeimWalter: What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant ther…

Oct 23, 2024 · 1 share · 6,608 followers View post →
freedom
@Us2021A · X

@RobertKennedyJr https://t.co/DoukRGA1dc Give this a read

Aug 12, 2024 · 4,887 followers View post →
たまのきゅうか
@yutomsm · X

こちらが最初のSTAR*D再解析論文。こちらでは寛解率はトータルで35%に落ちるよという結果。どう考えたらいいものか。 https://t.co/fxQNGgsDPz

Jun 22, 2024 · 1,555 followers View post →
Eric DOURIEZ
@edouriez · X

What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapies in real-world depressed patients? e063095.full.pdf https://t.co/haFfWNemn2

Jun 13, 2024 · 1,988 followers View post →
Walter Keim
@KeimWalter · X

What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapies in real-world depressed patients? Reanalysis of the STAR*D study's patient-level data with fidelity to the original research https://t.co/zN2Vie4Qyu

Mar 27, 2024 · 1 like · 1 share · 184 followers View post →
Lasse Mattila
@Lasse_Mattila · X

#8 Månadens nyheter: Internationella varningar för ADHD-läkemedel; granskningshärvan kring Fråga doktorn-inslag; STAR*D-skandalen och antidepressiva läkemedel: https://t.co/B6jIKsC3ks #MånadensNyheter #ADHD #FrågaDoktorn #SVT #Granskningsnämnden #STARD #Antidepressiva

Sep 29, 2023 · 2 likes · 542 followers View post →
おラム映画は大映
@lambda474 · X

RT @Luke_629: What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapie…

Sep 28, 2023 · 9 shares · 792 followers View post →
desastroeses_hoernchen #MHNursingIsPolitical
@desastroeses · X

RT @psychepi: What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapie…

Sep 3, 2023 · 21 shares · 1,339 followers View post →
青柳
@FBWM8888 · X

RT @Luke_629: What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapie…

Aug 13, 2023 · 9 shares · 724 followers View post →
Toshiharu Kamishikiryo
@k5105880 · X

RT @Luke_629: What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapie…

Aug 12, 2023 · 9 shares · 58 followers View post →
Kazu@精神科医 MD&PhD
@peacewaffle · X

RT @Luke_629: What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapie…

Aug 12, 2023 · 9 shares · 667 followers View post →
Felipe Guillen, M.D
@pipeguillenMD · X

What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapies in real-world depressed patients? A reanalysis of the STAR*D study's patient-level data to the original research protocol https://t.co/SSeTxSTSV6

Aug 12, 2023 · 1,325 followers View post →
thmonk
@thmonk_pf · X

RT @Luke_629: What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapie…

Aug 12, 2023 · 9 shares · 1,651 followers View post →
TT /精神科備忘録
@EgBopt37gajSY4H · X

RT @Luke_629: What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapie…

Aug 12, 2023 · 9 shares · 202 followers View post →
llontyanne
@iron_tyanne · X

RT @Luke_629: What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapie…

Aug 12, 2023 · 9 shares · 117 followers View post →
あるく
@ayumu_tomaru · X

RT @Luke_629: What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapie…

Aug 11, 2023 · 9 shares · 297 followers View post →
yoshiyuki nishio
@nishiokov · X

RT @Luke_629: What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapie…

Aug 11, 2023 · 9 shares · 519 followers View post →
Luke Nakaji/中島 振一郎@バルサと島巡りと猫と精神医療
@Luke_629 · X

What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapies in real-world depressed patients? A reanalysis of the STAR*D study's patient-level data with fidelity to the original research https://t.co/obJ7R6ur13

Aug 11, 2023 · 46 likes · 9 shares · 2,279 followers View post →
Max Andrade
@psycheparaiba · X

RT @CarlatPsych: Was STAR*D wrong? New analysis finds #depression trial did not follow its protocols. With a more conservative approach, th…

Aug 11, 2023 · 9 shares · 203 followers View post →
A Punk Rock Future
@APunkRockFuture · X

RT @chrisaikenmd: Was STAR*D wrong? New analysis finds #depression trial did not follow its protocols. With a more conservative approach, t…

Aug 11, 2023 · 16 shares · 1,332 followers View post →
Carlat Psychiatry
@CarlatPsych · X

Was STAR*D wrong? New analysis finds #depression trial did not follow its protocols. With a more conservative approach, they estimated 35% remitted after at <=4 treatment attempts, much less than the original 67% -@ChrisAikenMD https://t.co/sV4wrOmx6J #psychiatry #clinicaltrials https://t.co/oISGGxq5hZ

Aug 11, 2023 · 35 likes · 9 shares · 8,078 followers View post →
gabafeitina
@gabrielbasto_ · X

RT @chrisaikenmd: Was STAR*D wrong? New analysis finds #depression trial did not follow its protocols. With a more conservative approach, t…

Aug 11, 2023 · 16 shares · 101 followers View post →
Marko Paşa
@markopaassa · X

RT @chrisaikenmd: Was STAR*D wrong? New analysis finds #depression trial did not follow its protocols. With a more conservative approach, t…

Aug 11, 2023 · 16 shares · 152 followers View post →
Agnes Ayton
@AgnesAyton · X

RT @chrisaikenmd: Was STAR*D wrong? New analysis finds #depression trial did not follow its protocols. With a more conservative approach, t…

Aug 11, 2023 · 16 shares · 7,429 followers View post →
Austin Lam
@austinaldenlam · X

RT @chrisaikenmd: Was STAR*D wrong? New analysis finds #depression trial did not follow its protocols. With a more conservative approach, t…

Aug 11, 2023 · 16 shares · 1,084 followers View post →
Dr. Tahoora Ali
@drtahooraali · X

RT @chrisaikenmd: Was STAR*D wrong? New analysis finds #depression trial did not follow its protocols. With a more conservative approach, t…

Aug 11, 2023 · 16 shares · 365 followers View post →
Mario Perales
@Dr_MarioPerales · X

RT @chrisaikenmd: Was STAR*D wrong? New analysis finds #depression trial did not follow its protocols. With a more conservative approach, t…

Aug 11, 2023 · 16 shares · 67 followers View post →
Chris Aiken, MD
@chrisaikenmd · X

Was STAR*D wrong? New analysis finds #depression trial did not follow its protocols. With a more conservative approach, they estimated only 35% remitted after at <=4 treatment attempts, much less than the original 67% https://t.co/FyTcLNWJRH #psychiatry #clinicaltrials https://t.co/dR0aiBKUTv

Aug 11, 2023 · 73 likes · 16 shares · 8,481 followers View post →
Scientology Switzerland
@Scientology_CH · X

RT @Altostrata: Gold standard STAR*D study supposedly showing remission from antidepressant treatment continues to stink. 35% remitted. Wh…

Aug 3, 2023 · 3 shares · 805 followers View post →
Jem
@mc_cabe3 · X

RT @Altostrata: Gold standard STAR*D study supposedly showing remission from antidepressant treatment continues to stink. 35% remitted. Wh…

Aug 2, 2023 · 3 shares · 367 followers View post →
Kindly #deprescribe -- taper psychiatric drugs
@Altostrata · X

Gold standard STAR*D study supposedly showing remission from antidepressant treatment continues to stink. 35% remitted. What are the treatment remission, response and extent of improvement rates...A reanalysis of the STAR*D study’s patient-level data.... https://t.co/dxKxBKc1ST

Aug 1, 2023 · 4 likes · 3 shares · 6,608 followers View post →
Wren Cage
@_eleven13_ · X

RT @MedicatingNorm1: Article from the BMJ: "What are the treatment remission, response and extent of improvement rates after up to four tri…

Jul 31, 2023 · 1 share · 2,761 followers View post →
Medicating Normal
@MedicatingNorm1 · X

Article from the BMJ: "What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapies in real-world depressed patients?" Article Link: https://t.co/ABoWFCzxN3 #antidepressants

Jul 31, 2023 · 2 likes · 1 share · 5,394 followers View post →
Barney Dunn
@barneydunn75 · X

RT @psychepi: What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapie…

Jul 31, 2023 · 21 shares · 887 followers View post →
Leonhard Schilbach
@leoschilbach · X

RT @psychepi: What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapie…

Jul 30, 2023 · 21 shares · 6,752 followers View post →
Christian Webb
@ChrisWebbPhD · X

RT @psychepi: What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapie…

Jul 30, 2023 · 21 shares · 3,432 followers View post →
Zachary Cohen
@DepressionLab · X

RT @psychepi: What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapie…

Jul 30, 2023 · 21 shares · 3,401 followers View post →
Michael P. Hengartner, PhD
@HengartnerMP · X

RT @psychepi: What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapie…

Jul 30, 2023 · 21 shares · 8,052 followers View post →
Marketing Maven D
@d_a_n_i_e_l___b · X

RT @psychepi: What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapie…

Jul 29, 2023 · 21 shares · 152 followers View post →
Digital Edge Pro
@_d_a_n_i_e_l__b · X

RT @psychepi: What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapie…

Jul 29, 2023 · 21 shares · 219 followers View post →
Style Spectrum
@dan_brummitt · X

RT @psychepi: What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapie…

Jul 29, 2023 · 21 shares · 1,996 followers View post →
Bath Haven
@dan___brummitt · X

RT @psychepi: What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapie…

Jul 29, 2023 · 21 shares · 1,815 followers View post →
Rob Purssey
@RPurssey · X

RT @psychepi: What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapie…

Jul 29, 2023 · 21 shares · 817 followers View post →
Decor Dwell
@BrummittDan · X

RT @psychepi: What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapie…

Jul 29, 2023 · 21 shares · 1,517 followers View post →
Phone Case Guy
@DANIEL___SEO · X

RT @psychepi: What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapie…

Jul 29, 2023 · 21 shares · 2,890 followers View post →
Ink Verse
@ArtDealership · X

RT @psychepi: What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapie…

Jul 29, 2023 · 21 shares · 5,337 followers View post →
Ash Paul
@pash22 · X

RT @psychepi: What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapie…

Jul 29, 2023 · 21 shares · 32,318 followers View post →
Radoslaw Stupak
@RadoslawStupak · X

RT @psychepi: What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapie…

Jul 29, 2023 · 21 shares · 1,184 followers View post →
recovery&renewal
@recover2renew · X

RT @psychepi: What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapie…

Jul 29, 2023 · 21 shares · 4,171 followers View post →
Richard Gipps
@DrGipps · X

RT @psychepi: What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapie…

Jul 29, 2023 · 21 shares · 5,827 followers View post →
Melissa Raven
@psychepi · X

What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapies in real-world depressed patients? A reanalysis of the STAR*D study ... with fidelity to the original research … @BMJ_Open https://t.co/VULGhSJBio

Jul 29, 2023 · 34 likes · 21 shares · 2,458 followers View post →
STAR D Reanalysis | PDF | Major Depressive Disorder ...
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Reddit

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Reddit

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Reddit

BMJ open, 13(7), e063095. https://doi.org/10.1136/bmjopen-2022-063095. Steps in the algo are still alright, but of course today there are ...

Aug 16, 2025 View →
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Reddit

BMJ open, 13(7), e063095. https://doi.org/10.1136/bmjopen-2022-063095. I passaggi nell'algoritmo sono ancora a posto, ma ovviamente oggi ci ...

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Blogs

doi: 10.1136/bmjopen-2022-063095. 4. FDA Clears NeuroStar TMS for Treatment of MDD in Adolescents. Disclaimer: Dr. Brenner in is private ...

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What are the treatment remission, response and extent of ... - LinkedIn
LinkedIn

... patient-level data with fidelity to the original research protocol HE Pigott et al doi:10.1136/bmjopen-2022-063095.

Apr 2, 2024 View →
New Data Reveal the Full Extent of STAR*D Failure
Blogs

BMJ Open, 0, e063095. doi:10.1136/bmjopen-2022-063095 (Link). Previous articlePsychosis sensitivity; we lose contact with our body. Next ...

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