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CME

Expert Advice on MDD Treatment: When to Augment or Switch

Tool

Expert recommendations for when and how to augment or switch treatment for MDD.

Physicians: Maximum of 0.25 AMA PRA Category 1 Credit

Released: April 17, 2020

Expiration: April 16, 2021

No longer available for credit.

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Faculty

Leslie Citrome

Leslie Citrome, MD, MPH

Clinical Professor
Department of Psychiatry and Behavioral Sciences
New York Medical College
Valhalla, New York

Christoph U. Correll

Christoph U. Correll, MD

Professor of Psychiatry and Molecular Medicine
Zucker School of Medicine at Hofstra/Northwell
New York, New York
Professor and Chair
Department of Child and Adolescent Psychiatry
Charité University Medicine
Berlin, Germany

Rakesh Jain

Rakesh Jain, MD, MPH

Clinical Professor
Department of Psychiatry
Texas Tech Health Sciences Center, School of Medicine
Midland, Texas

Roger McIntyre

Roger McIntyre, MD, FRCPC

Professor of Psychiatry and Pharmacology
University of Toronto, Canada
Chairman and Executive Director, Brain and Cognition Discovery Foundation
Toronto, Canada
Board Chair, Depression and Bipolar Support Alliance
Board of Directors
Chicago, Illinois

Michael E. Thase

Michael E. Thase, MD

Professor of Psychiatry
Department of Psychiatry
Perelman School of Medicine at the University of Pennsylvania
Philadelphia, Pennsylvania

Provided by

Provided by Clinical Care Options, LLC

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Supporters

Supported by an educational grant from

Otsuka and Lundbeck Alliance

Target Audience

This activity is intended primarily for psychiatrists and primary care physicians who care for patients with MDD.

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Develop patient-tailored treatment plans that include guideline-directed augmentation strategies to manage residual MDD symptoms
  • Incorporate recommended assessment tools in the evaluation of the patient response to antidepressant therapy to guide treatment modification in MDD
  • Summarize the efficacy and safety of atypical antipsychotic therapies used to augment treatment of patients with MDD, especially in the setting of comorbidities such as cardiovascular disease

Disclosure

Clinical Care Options, LLC (CCO) requires instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose any relevant conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to CCO policy. CCO is committed to providing its learners with high-quality CME/CE activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME/CE activity:

Faculty Disclosure

Primary Author

Leslie Citrome, MD, MPH

Clinical Professor
Department of Psychiatry and Behavioral Sciences
New York Medical College
Valhalla, New York

Leslie Citrome, MD, MPH, Acadia, Alkermes, Allergan, Avanir, BioXcel, Eisai, Impel, Indivior, Intra-Cellular Therapies, Janssen, Lundbeck, Luye, Merck, Neurocrine, Noven, Osmotica, Otsuka, Pfizer, Sage, Shire, Sunovion, Takeda, Teva, and Vanda; has served on speaker bureaus for Acadia, Alkermes, Allergan, Janssen, Lundbeck, Merck, Neurocrine, Otsuka, Pfizer, Sage, Shire, Sunovion, Takeda, and Teva; and has ownership interest in Bristol-Myers Squibb, Johnson & Johnson, Lilly, Merck, and Pfizer.

Christoph U. Correll, MD

Professor of Psychiatry and Molecular Medicine
Zucker School of Medicine at Hofstra/Northwell
New York, New York
Professor and Chair
Department of Child and Adolescent Psychiatry
Charité University Medicine
Berlin, Germany

Christoph U. Correll, MD, has disclosed that he has received funds for research support from Janssen/Johnson & Johnson and Takeda; consulting fees from Alkermes, Allergan, Angelini, Gedeon Richter, Gerson Lehrman Group, IntraCellular Therapies, Janssen/Johnson & Johnson, LB Pharma, Lundbeck, MedAvante-ProPhase, Neurocrine, Noven, Otsuka, Pfizer, Recordati, Rovi, Sumitomo Dainippon, Sunovion, Supernus, Takeda, and Teva; fees for non-CME/CE services from Alkermes, Allergan, Angelini, Gedeon Richter, Janssen/Johnson & Johnson, Lundbeck, MedAvante-ProPhase, Otsuka, Pfizer, Recordati, Sumitomo Dainippon, Sunovion, and Takeda.

Rakesh Jain, MD, MPH

Clinical Professor
Department of Psychiatry
Texas Tech Health Sciences Center, School of Medicine
Midland, Texas

Rakesh Jain, MD, MPH, has disclosed that he has received consulting fees from Acadia, Alfasigma, Alkermes, Allergan, Eisai, Evidera, Impel, Janssen, Lilly, Lundbeck, Merck, Neos Therapeutics, Neurocrine, Osmotica, Otsuka, Pamlab, Pfizer, Shire, Sunovion, Supernus, Takeda and Teva; fees from non-CME/CE services from Alkermes, Allergan, Ironshore Pharmaceuticals, Janssen, Lilly, Lundbeck, Merck, Neos Therapeutics, Neurocrine, Otsuka, Pamlab, Pfizer, Shire, Sunovion, Takeda, Teva and Tris Pharmaceuticals; and funds for research support from Allergan, Lilly, Lundbeck, Otsuka, Pfizer, Shire, and Takeda; and that his spouse/partner has received consulting fees from Lilly, Otsuka, Pamlab, and Sunovion and fees for non-CME/CE services from Lilly.

Roger McIntyre, MD, FRCPC

Professor of Psychiatry and Pharmacology
University of Toronto, Canada
Chairman and Executive Director, Brain and Cognition Discovery Foundation
Toronto, Canada
Board Chair, Depression and Bipolar Support Alliance
Board of Directors
Chicago, Illinois

Roger McIntyre, MD, FRCPC, has disclosed that he has received consulting fees and fees for non-CME/CE services from Allergan, Janssen, Lundbeck, Minerva, Neurocrine, Otsuka, Pfizer, Purdue, Shire, Sunovion, and Takeda.

Michael E. Thase, MD

Professor of Psychiatry
Department of Psychiatry
Perelman School of Medicine at the University of Pennsylvania
Philadelphia, Pennsylvania

Michael E. Thase, MD, has disclosed that he has received funds for research support from Acadia, Allergan, Axsome, Intracellular, Johnson & Johnson, Otsuka, and Takeda and consulting fees from Acadia, Akili, Alkermes, Allergan, H. Lundbeck, Jazz, Johnson & Johnson, Merck, Otsuka, and Pfizer.

Staff Disclosure

Staff

Anne Roc, PhD

Director, Scientific Services

Anne Roc, PhD, has no relevant conflicts of interest to report.

Zachary Schwartz, MSc, ELS

Scientific Director

Zachary Schwartz, MSc, has no relevant conflicts of interest to report.

Instructions for Credit

Accreditation

Joint Accreditation Statement

In support of improving patient care, Clinical Care Options, LLC (CCO) is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physician Continuing Medical Education

Credit Designation

CCO designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Additional Information

Participation in this self-study activity should be completed in approximately 0.25 hours. To successfully complete this activity and receive credit, participants must follow these steps during the period from April 17, 2020, through April 16, 2021:

1. Register online at http://www.clinicaloptions.com.
2. Read the target audience, learning objectives, and faculty disclosures.
3. Enter patient details and submit case.
4. Review the patient case online or printed out.
5. Submit answers to the Clinical Implications questions and evaluation questions online.

You must respond to all Clinical Implications and evaluation questions to receive credit. After submitting the evaluation, you may access your online certificate by selecting the certificate link on the posttest confirmation page. Records of all CME/CE activities completed can be found on the "CME/CE Manager" page. There are no costs/fees for this activity.

Program Medium

This program has been made available online.

 

Goal


The goal of this activity is to improve the learner’s competence in selecting treatment augmentation modalities (eg, dosage changes, antidepressant switching, adding atypical antipsychotic) for patients with MDD who respond suboptimally to antidepressant therapy.