April 3, 2025 • Brooke Siem
I have 16,715 days to live—and other news on antidepressant withdrawal: STAR*D, The Awed Life Podcast, and Why Science Does Not Disprove God
Hi friends,
When you’re reading this, I will be on my way to another continent to celebrate both my mom’s and my birthdays. And on the day of my birthday—February 1—I will have 16,715 more days to live.
Maybe. Hopefully.
My father died suddenly when he was 54. That means he was halfway through at 27 and still had 13 years of living before I came along. I don’t have the vocabulary to express how much that twists my mind, and yet it’s been a constant thought over this year. I don’t know if it’s because 54 no longer feels all that old or far away, or because no one ever knows when they’re halfway done.
I turn to numbers for comfort. Always have. Even as a girl, when I felt overwhelmed, I would quietly calm myself by counting ceiling tiles or cars passing in the other direction.
In the depths of depression—despite years of antidepressants—I took a dozen life expectancy tests, sourced from life insurance companies and accounting firms. I averaged the results for a total of 83 years, 9 months, and 6 days on this planet. Or 30,595 sunsets.
I didn’t want those sunsets until I got off all the antidepressants and came out of a year of severe antidepressant withdrawal. But after all the suffering and all the deep work, finally, I want time. I want all the days I never thought I’d have.
If I am so lucky to see them all, that means I get to watch the leaves turn 46 more times.
And read just 920 more books.
And watch 11 more Summer Olympics.
There will be maybe 138 more pizzas and 33,430 cups of coffee. Assuming there’s always a canine by my side, I’ll take 66,860 more walks with 4 more dogs.
I’ll hug that friend I only see once every few years about 15 more times.
And feel lucky if I laugh until I cry 92 more times.
Maybe I get half a dozen moments of complete and utter awe.
And one great love.
Maybe. Hopefully.
All this to say:
I don’t know how many more mother/daughter trips I have left, especially grand international ones. I will be happily unavailable for a few weeks and want to make sure you have your fill of the latest news on antidepressant withdrawal, so I have compiled a bunch of recent articles below.
There was a time when maybe one article was written on the topic every three months, and now I’m starting to see weekly (and even daily) headlines. Something is shifting. I can feel it, and I welcome it.
STAR*D Dethroned? in the Psychiatric Times
The STAR*D trial, once considered a landmark study in psychiatry, is now mired in controversy due to findings of protocol violations, inflated remission rates, and a general lack of accountability from its investigators.
One of the largest and longest studies on antidepressants, the trial initially reported a 67% effectiveness rate for antidepressants, which became the basis for the pharmaceutical focus that has shaped much of modern psychiatric “care.” However, the trial has come under scrutiny for several reasons, revealing a far different picture of its findings:
- Deviation from Protocol and Inflated Remission Rates: The trial’s investigators, funded by the National Institute of Mental Health (NIMH), deviated from the original study protocol in ways that significantly inflated the remission rates. Psychologist Ed Pigott and his colleagues, after a thorough investigation that began in 2006, found that the cumulative remission rate (if the protocol had been strictly followed) would have been 38% rather than the reported 67%. Said another way, the original findings overstated the effectiveness of the antidepressants by almost double.
- Inclusion of Ineligible Patients: The investigation found that the STAR*D trial included 607 patients in their analysis who had baseline scores on the Hamilton Rating Scale for Depression (HRSD) that were below the threshold required for study entry. This inclusion of patients who were not severely depressed artificially boosted the remission rates reported by the study.
- Switching of Outcome Measures: The study initially stated that HRSD would be the primary tool for measuring depressive symptoms. However, during the trial, the researchers also used the Quick Inventory of Depressive Symptoms (QIDS-SR), which showed higher remission rates than HRSD. The switch to this more lenient scale added more than 200 patients to the remitted group, further inflating the study’s results.
- Misrepresentation of Stay-Well Rates: The actual number of patients who remained well throughout a year of continuing care was much lower than reported. Only about 3% of the patients who entered the trial remitted and stayed well during the year-long follow-up, a figure starkly lower than the impression given by the original study.
- Lack of Response from Investigators: Despite the significant issues raised, the STAR*D investigators have largely remained silent or unresponsive to these allegations. When the BMJ Open prepared to publish Pigott’s reanalysis, the STAR*D investigators were invited to respond but declined. This lack of engagement has been seen as a tacit acknowledgment of the issues raised by Pigott and others.
- Impact on Public Trust and Clinical Practice: The revelations about the STAR*D trial have broader implications for public trust in psychiatric research and the clinical application of its findings. The study, which was designed to guide clinical care, is now seen as having provided misleading information about the effectiveness of antidepressants. This has raised concerns about the ethical standards and reliability of psychiatric research, particularly given the lack of action from the American Psychiatric Association and other academic institutions in addressing these issues.
More articles from the blog
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April 17, 2025
Every medical test I used to heal my body after 15 years of antidepressants: Actual medicine, unlike what’s going on in psychiatry
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April 10, 2025
Letter from a past life: What I found after scrubbing the screws on my toilet.
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March 27, 2025
