An important observation from the STAR*D Study was that a large number of patients in each treatment group did not actually reach remission after 6 to 8 weeks of treatment. Thus, the remission state may indeed take more time to achieve in comparison with a simple response in antidepressant trials. Thus, future trials designed to assess remission as the primary end point, in acute treatment studies should probably last at. least. 8 weeks, and maybe more. Conclusion

Inhibitors,research,lifescience,medical There is general consensus to consider remission after acute antidepressant treatment as the gold standard and main objective of modern antidepressant therapy, but, before the dream becomes reality for the great majority of our depressed patients, innovative strategies and novel etiology-based therapeutic Inhibitors,research,lifescience,medical approaches will have to be explored in rigorous controlled investigations combining creative clinical expertise and innovative biomarker research. Selected abbreviations and acronyms HAM – D17 Hamilton Rating Scale

for Depression – 17 items HAMD-D7 Toronto Hamilton Rating Scale for Depression – 7 items MADRS Montgomery Åsberg Depression Rating Scale MIDAS Rhode Island Method to Improve Assessments Inhibitors,research,lifescience,medical and Services
The concept of depression as a disease goes back a long way. Hippocrates described melancholia as a condition in which patients had fears and despondencies for a long time.1 Robert ATM Kinase Inhibitor order Burton’s book, Anatomy of Melancholy, from 1621, is a most interesting read, and many of the descriptions are still applicable.2 In the last 200 years many concepts have been introduced into the classification of depression, including

manic-depressive disorder/insanity,3 bipolar disorder,4 and depression.5,6 Kraepelin’s Inhibitors,research,lifescience,medical original concept of manic-depressive disorder has evolved into the concept of polarity, and bipolar and depressive disorders. During the last century, psychiatric Inhibitors,research,lifescience,medical classification has been characterized by an inflation of diagnostic categories, and this includes the numerous subtypes of depression (see the plethora of DSM classification systems). Severity, duration, Thiamine-diphosphate kinase and recurrence are used as bases for classification. This rapid multiplier effect is primarily descriptive, and there is a need to rethink, in a pragmatic fashion, the classification system in order to create one that is likely to be of utility and based on science. As we move towards a classification of depression for this century, it is worth taking a look at the basics of what “disease” is. Disease is an attribute of the patient. Trie major reason for having a disease label is to convey information in shortened form to others, such that it provides key information on the nature and perhaps the treatment of the condition. So, if someone states that a patient has chronic obstructive pulmonary disease, everyone else knows what this means. Disease is conceptualized and taught as an invariant concept, but it is not one.