The Sequenced Treatment Alternatives to Relieve Depression (STAR*D) Study, funded by the NIH National Institute of Mental Health, is a nationwide public health clinical trial. The purpose of the trial is to determine the effectiveness of different treatments for people with Major Depressive Disorder (MDD) who have not responded to initial treatment with an antidepressant. This is the largest and longest study ever done to evaluate depression treatment. Over a seven-year period, the study enrolled more than 4,000 outpatients, aged 18-75 years. The participants were people who came to their doctors for care and who had other psychiatric and medical conditions like those regularly seen in typical clinical practices (see Ref 1). Patients from both mental health (specialty care) and non-mental health (primary medical care) practices in diverse racial, ethnic, and socioeconomic populations were enrolled in the study.