The findings of the last stage of a groundbreaking study on depression suggested that two thirds of patients in the study showed no signs and symptoms of depression after trying up to 4 different drug combinations and therapies. The federal study included 3671 participants.

The 6-year, $35-million study evaluated a variety of depression medications in "real-world" settings"—patients seeking help at community clinics and physician offices. Of the 3671 adults with major depression, 50% had a family history of it, and >50% had experienced multiple bouts themselves. All of the participants were started on Forest Laboratories' Celexa (citalopram HBr).

The study's findings, reported in the American Journal of Psychiatry (November 2006), showed that nearly 37% saw their depression go into remission after the first attempt. The remaining participants switched to another antidepressant or continued with Celexa and added a second treatment. The second-treatment option helped 31% of the group. Results were seen in 3 and 4 attempts with success rates of 14% and 13%, respectively. When the researchers pooled all the results, they determined that 67% of the study group had been helped by 1 or more drugs.

The patients were not cured. Those who did improve or reach remission in fewer treatment steps, however, had lower relapse rates during a yearlong follow-up period than those who had to go through more steps to improve or achieve remission.

"I think the overall results are hopeful," commented Thomas Insel, MD, director of the National Institutes of Mental Health. "The problem with depression is that people and their families feel hopeless. The message here is that medication can be helpful."