News - Melbourne Medibrain Centre

Clinical Psychiatry News, Vol. 7 No. 2 2011

rEEG

Referenced rEEGs may guide Depression treatment better than STAR*D Algorithm

The STAR*D algorithm study, published in 2006, is a four-step treatment algorithm; most patients start at level 1 with citalopram. If they do not enter remission within 14 weeks, they either switch drugs or add another medication; this pattern can continue for four levels, ending with tranylcypromine or mirtazapine plus extended-release venlafaxine. The trial by Dr DeBattista and his colleagues randomized 114 patients with treatment resistant depression. After undergoing a drug washout period consisting of five consecutive half-life days, patients in the active group were randomized to a treatment regimen based on rEEG, constructed after review of their baseline EEG. Control patients who had failed only selective serotonin reuptake inhibitors received extended-release venlafaxine; those who had failed two or more classes of antidepressants received a medication regime from steps 2-4 of STAR*D.