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University of Texas South-western Medical Center |
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A.J. Rush, MD |
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M.H. Trivedi, MD |
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Massachusetts General Hospital |
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M. Fava, MD |
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A. Nierenberg, MD |
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J.F. Rosenbaum, MD |
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University of Pittsburgh Medical Center |
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M. Thase, MD |
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R. Howland, MD |
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D.J. Kupfer, MD |
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S. Wisniewski, PhD |
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Columbia University College of Physicians &
Surgeons |
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F. Quitkin, MD |
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H. Sackeim, PhD |
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P. McGrath, MD |
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Level 1: CIT |
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Level 2: |
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Switch: BUP, CT, SER, VEN |
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Augment: BUP, BUS, CT |
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Level 3: |
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Switch: NOR, MIR |
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Augment: Li, THY |
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Level 4: |
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Switch: TCP, VEN + MIR |
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N = 4,000 |
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MDD, nonpsychotic |
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Specialty and primary care |
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Almost all comorbidities |
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Research outcomes separated from clinical
practice |
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12 weeks/Level |
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1-year follow-up |
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What are the best options for Levels 2, 3, 4,
etc.? |
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Which options are most acceptable? |
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Do pretreatment indicators help in selecting
among treatment(s)? |
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What is an adequate trial (dose, duration)? |
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Are guidelines (protocols) more effective
(? less costly) than TAU? |
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How long do acute phase benefits last? |
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Are particular pharmacotheoretical notions
valid? |
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5-year study |
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12 to 14 Regional Sites |
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More than 72 clinicians |
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Independent evaluators |
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4,000 depressed patients treated openly |
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2,000 likely to not remit after first treatment |
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Randomization at Levels 2-4 only to treatment
options acceptable to patient participants |
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Evaluation of outcomes in multiple domains |
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Notes