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Improving Remission Rates in Major Depressive Disorder:
A Case-Based Approach

Supported by an educational grant from Otsuka America Pharmaceutical Inc. and Lundbeck. Brought to you through the joint providership of the CME Institute of Physicians Postgraduate Press, Inc., Medical Education Resources, and CMEology.

Participants may receive credit by reading the activity, correctly answering the posttest question, and completing the evaluation.

Objectives

After completing this educational activity, you should be able to:

  • Employ evidence-based augmentation and switching strategies for patients with an inadequate response to treatment for major depressive disorder (MDD)
  • Identify patient factors when addressing inadequate response to treatment for MDD, eg, overweight, childhood adversity, sleep disturbances, cognitive dysfunction
  • Review new evidence on the use of pharmacogenetics testing and MDD outcomes

Financial Disclosure

The faculty for this CME/CE activity and the CME Institute and CMEology staffs were asked to complete a statement regarding all relevant personal and financial relationships between themselves or their spouse/partner and any commercial interest. The CME Institute has resolved any conflicts of interest that were identified. No member of the CME Institute, Medical Education Resources, or CMEology staff reported any relevant personal financial relationships. Faculty financial disclosure is as follows:

Dr McIntyre is a member of the advisory boards for and has received speakers fees from Lundbeck, Pfizer, AstraZeneca, Eli Lilly, Ortho-McNeil-Janssen, Purdue, Johnson & Johnson, Moksha8, Sunovion, Mitsubishi, Takeda, Forest, Otsuka, Bristol-Myers Squibb, and Shire and has received research grants from Allergan, AstraZeneca, Lundbeck, Otsuka, Pfizer, Purdue, Shire, Takeda, and Stanley Medical Research Institute.

Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the CME Institute of Physicians Postgraduate Press, Inc, Medical Education Resources, and CMEology. The CME Institute is accredited by the ACCME to provide continuing medical education for physicians. Medical Education Resources is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

Credit Designation

The CME Institute of Physicians Postgraduate Press, Inc., designates this enduring material for a maximum of 2.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Medical Education Resources designates this activity for 2 contact hours of continuing nursing education.

Medical Education Resources is approved by the California Board of Registered Nursing, Provider Number 12299, for 2.0 contact hours.

The American Academy of Physician Assistants (AAPA) accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society. Physician assistants may receive a maximum of 2.0 hours of Category I credit for completing this program.

To obtain credit for this activity, study the material and complete the CME Posttest and Evaluation.

Release, Review, and Expiration Dates

This Health Spectrum™ activity was published in November 2017 and is eligible for AMA PRA Category 1 Credit™ through November 30, 2018. The latest review of this material was November 2017.

Learning Goal/Purpose

The goal of this activity is to educate health care providers on evidence-based treatment strategies for patients with major depressive disorder (MDD) who have had an inadequate response to treatment.

Statement of Need and Purpose

MDD is one of the most frequently encountered conditions in clinical psychiatry. Despite the availability of efficacious and well-tolerated medications for the treatment of MDD, only one-third of patients diagnosed with MDD achieve remission with their initial treatment. It is thought that there are over 4 million US adults who are inadequately treated for MDD. Surveys of psychiatrists, nurse practitioners, and other clinicians who treat patients with MDD have found that a significant proportion of the respondents’ patients failed to have an adequate response to a trial of one or two antidepressants. When asked what treatment strategies were used beyond first-line therapy, the respondents revealed inconsistent and sometimes inappropriate approaches to management of inadequate MDD treatment response. In particular, the use of adjunctive therapies suggested a need for education on the current evidence for specific MDD treatment strategies. This activity was designed to meet the needs of participants in CME/CE activities provided by the CME Institute of Physicians Postgraduate Press, Inc., and Medical Education Resources who have requested information on depression.

Disclosure of Off-Label Usage

Dr McIntyre has determined that, to the best of his knowledge, ketamine is not approved by the US Food and Drug Administration for the treatment of major depressive disorder.

Review Process

The faculty of the activity discussed the content at a planning session and reviewed the activity for accuracy and fair balance, and a member of the External Advisory CME Board who is without conflict of interest reviewed the activity to determine whether the material is evidence-based and objective.

Acknowledgment

This Health Spectrum activity is derived from the planning sessions for “Improving Remission Rates in Major Depressive Disorder: A Case-Based Approach,” which were held in March 2017 and supported by an educational grant from Otsuka America Pharmaceutical Inc. and Lundbeck. The opinions expressed herein are those of the faculty and do not necessarily reflect the views of the CME/CE providers, publisher, the joint provider, or the commercial supporters.