The results of many clinical trials cannot be generalized to the Yoga poses knee pain population of patients seen in most practice settings because the commonly used exclusion criteria preselect patients with Yoga poses knee pain uncomplicated depression.
Recognizing this problem, the National Institute of Mental Health funded Sequenced Treatment Alternatives to Relieve Depression STAR*D, a more naturalistic study of 4,000 patients including those with chronic depression and comorbid psychiatric and medical conditions Trivedi, Rush, Wisniewski, Nierenberg, Warden et al., 2006.
To simulate the most widely used approaches in psychiatric and primary care settings, patients were initially treated with a selective serotonin reuptake inhibitor SSRI, in this study citalopram Celexa in doses up to 60 mg/day. The remission rate was only 27% response rate 47%. Nonresponders were augmented or switched to other antidepressants with about a 30% remission rate Trivedi et al. Most studies of antidepressants exclude patients with anxiety disorder, personality disorder, suicide attempts, long duration of illness, substance abuse, and medical disorders or those who were previously unresponsive to treatment. This means that 60-80% of your patients would not qualify for an antidepressant study.
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