 Efficacy, Safety, and Tolerability Considerations in the Novel Treatment of Major Depressive Disorder (66 Minutes)
Faculty: Andrew Nierenberg, MD, Sidney Kennedy, MD, FRCPC, R. Bruce Lydiard, PhD, MD, Mark Hyman Rapaport, MD
This CME Expert Review PsychCast™ is jointly sponsored by the Mount Sinai School of Medicine and MBL Communications.
Release Date: June 5, 2009
Termination Date: June 5, 2011
Estimated time to complete this activity: 1 hour
Medium: The content is delivered by PsychCast™ with a PDF or web-based Posttest
Acknowledgment of Commercial Support: Funding for this activity has been provided by an educational grant from Bristol-Myers Squibb.
Activity Review Information: The activity content has been peer-reviewed by Sanjay J. Mathew, MD. Review Date: February 5, 2009.
Faculty Affiliation
Dr. Nierenberg is co-director of the Bipolar Clinic and Research Program and associate director of the Depression Clinical and Research Program at Massachusetts General Hospital, and professor of psychiatry at Harvard Medical School in Boston.
Dr. Kennedy is professor of psychiatry at the University of Toronto, and is psychiatrist-in-chief at the University Health Network in Toronto.
Dr. Lydiard is a professor in the Department of Psychiatry and Behavioral Sciences at the Medical University of South Carolina in Charleston.
Dr. Rapaport is chairman and professor of psychiatry and behavioral neurosciences, and the Poiler Endowed Chair in Schizophrenia and Related Disorders at Cedars-Sinai Medical Center and vice chairman and professor in residence in the Department of Psychiatry and Biobehavioral Sciences at the David Geffen School of Medicine at UCLA.
Faculty Disclosure Policy Statement
It is the policy of the Mount Sinai School of Medicine to ensure objectivity, balance, independence, transparency, and scientific rigor in all CME-sponsored educational activities. All faculty participating in the planning or implementation of a sponsored activity are expected to disclose to the audience any relevant financial relationships and to assist in resolving any conflict of interest that may arise from the relationship. Presenters must also make a meaningful disclosure to the audience of their discussions of unlabeled or unapproved drugs or devices. This information will be available as part of the course material.
Faculty Disclosure
Dr. Nierenberg is a consultant to or serves on the advisory boards of Abbott, Appliance Computing Incorporated MindSite, AstraZeneca, Basilea, Brain Cells, Bristol-Myers Squibb, Eli Lilly, Genaissance, GlaxoSmithKline, Innapharma, Jazz, Merck, the National Institute of Mental Health (NIMH), Novartis, Ortho-McNeil/Janssen, Pfizer, PGx Health, Schering-Plough, Sepracor, Shire, Somerset, Takeda, and Targacept; is on the speaker’s bureaus of Bristol-Myers Squibb, Cyberonics, Forest, Eli Lilly, GlaxoSmithKline, Massachusetts General Hospital Psychiatry Academy, and Wyeth; receives research support from Bristol-Myers Squibb, Cederroth, Cyberonics, Forest, Eli Lilly, GlaxoSmithKline, Lichtwer Pharma, NARSAD, NIMH, Ortho-McNeil/Janssen, Pamlab, Pfizer, the Stanley Foundation, and Wyeth; receives honoraria from Massachusetts General Hospital Psychiatry Academy; and owns stock in Appliance Computing Incorporated MindSite.
Dr. Kennedy is a consultant to and on the advisory boards of Advanced Neuromodulation Systems (ANS), AstraZeneca, Biovail, Eli Lilly, Lundbeck, Pfizer, Servier, and Wyeth; is on the speaker’s bureau of ANS, AstraZeneca, Biovail, Boehringer-Ingelheim, Eli Lilly, Lundbeck, Servier, and Wyeth; and receives research support from ANS, AstraZeneca, the Canadian Institutes of Health Research, Eli Lilly, GlaxoSmithKline, Lundbeck, NARSAD, the Ontario Mental Health Foundation, the Ontario Problem Gambling Research Society, and the Stanley Foundation.
Dr. Lydiard is a consultant to Eli Lilly and Takeda; and has received research support from AstraZeneca, Bristol-Myers Squibb, Eli Lilly, Forest, Pfizer, sanofi-aventis, UCB Pharma, and Wyeth. He discusses unapproved/investigational uses of quetiapine.
Dr. Rapaport is consultant to Astellas, Brain Cells, Cyberonics, Dainippon-Sumitomo, the National Institute of Mental Health, and Wyeth; and receives research support from AstraZeneca, the National Center for Complementary and Alternative Medicine, the National Institute of Mental Health, Pfizer and Solvay. He discusses unapproved/investigational uses of celecoxib, MK-801.
CME Course Director James C.-Y. Chou, MD, is associate professor of psychiatry at Mount Sinai School of Medicine. Dr. Chou has received honoraria from AstraZeneca, Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, Janssen, and Pfizer.
Dr. Mathew is associate professor of psychiatry at Mount Sinai School of Medicine. Dr. Mathew has served as an advisor/consultant to AstraZeneca and Jazz.
Learning Objectives
At the completion of this activity, participants should be better able to:
• Estimate barriers to treatment response for patients with major depressive disorder (MDD) to limit a chronic course of illness
• Evaluate the role of novel treatments for patients with MDD who do not achieve full remission
• Explain the efficacy, safety, and tolerability of novel treatment options available for MDD
Target Audience: This activity is designed to meet the educational needs of primary care physicians and psychiatrists.
Accreditation Statement: This activity has been planned and implemented in accordance with the Essentials Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the Mount Sinai School of Medicine and MBL Communications, Inc. The Mount Sinai School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.
Credit Designation: The Mount Sinai School of Medicine designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Disclaimer: These are the opinions of the authors not of the sponsors or supporters. For more information, contact MBL Communications at cme@mblcommunications.com.
Minimum Hardware/Software Requirements
Macintosh: PowerPC processor, Mac OS 8.6, 9.0.4, 9.1, or Mac OS X, 64MB of RAM, 24MB of available hard-disk space, and Safari 1.x or 2.x.
Windows PC: Intel Pentium processor, Microsoft Windows 95 OSR 2.0, Windows 98 and 98 SE, Windows Millennium Edition, Windows NT 4.0 with Service Pack 5, Windows 2000, or Windows XP, 64MB of RAM, 24MB of available hard-disk space, and Internet Explorer 6.x and newer or Firefox 1.x and newer.
This CME Activity and Posttest information file is a PDF (Portable Document Format) document. To view this file, you will need Adobe Acrobat Reader, which is available free at www.adobe.com. Follow the instructions on that page to download and install the software.
Efficacy, Safety, and Tolerability Considerations in the Novel Treatment of Major Depressive Disorder
(66 Minutes)
Faculty: Andrew Nierenberg, MD, Sidney Kennedy, MD, FRCPC, R. Bruce Lydiard, PhD, MD, Mark Hyman Rapaport, MD
Statement of Need and Purpose
Major depressive disorder (MDD) is a chronic condition, especially in cases that do not respond easily to treatment. Despite the availability of different classes of drugs for the treatment of MDD, there are a number of clinically significant unmet needs, such as a high prevalence of drug resistance, partial response, subsyndromal symptomatology, recurrence, and relapse. Treatment resistant depression (TRD) is frequently defined as depressive illness that does not fully remit after a single initial treatment failure. Up to 50% of patients in primary care settings do not show a full response to their first antidepressant treatment. The likelihood of successful treatment of MDD decreases with an increasing number of unsuccessful treatment attempts. There is a higher frequency of suicide in patients with TRD as opposed to those with treatment responsive MDD.
The strengths and limitations of selective serotonin reuptake inhibitors and selective norepinephrine reuptake inhibitors have been realized, as many patients do not respond well to initial antidepressant treatment or achieve remission. This has led to a re-emergence of interest in treatment augmentation research. It is apparent that mood regulation involves multiple neurotransmitter systems, and this widens the potential for chemical manipulation and, thus, treatment options. The advent of atypical antipsychotics has had a major impact in schizophrenia and may offer clinical advantages in mood regulation beyond bipolar disorder. Clinicians need to be made aware of recent medical advances related to depression in order to improve their treatment capabilities. Patients who only achieve partial response or continue to experience residual symptoms are likely to show reduced functioning and an increased risk of relapse.
To receive credit for this activity: Listen to the PsychCast™, reflect on the material presented, and complete the online CME Posttest/Evaluation here or to submit the CME Posttest/Evaluation by mail or fax, download a PDF here. To obtain credit, you should score 70% or better. The estimated time to complete the PsychCast™ and the posttest and evaluation is 1 hour. Successful completion of the posttest and evaluation will allow you to claim credit and print a certificate.
Early submission of this posttest is encouraged: please submit by June 1, 2011 to be eligible for credit. If you have any questions, please e-mail cme@mblcommunications.com.
Read the extended CME supplement related to this PsychCast™ activity here
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