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When an initial medication treatment is unsuccessful for a depressed patient, the psychiatrist might switch to or augment with psychotherapy or another medication. The Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial was set up to compare the effectiveness of seven treatment options (four switches and three augmentations, including cognitive-behavioral therapy). First, 4041 patients with major depression from primary care and psychiatric clinics were enrolled in a 12-week trial of the SSRI citalopram. Of these, 1439 patients did not achieve remission or could not tolerate citalopram and entered the next phase, which used an “equipoise stratified” randomized design to allow for some patient preferences in treatment assig…