DISCLAIMER:

This activity was originally presented as a LIVE dinner meeting series in 2011. If you received credit for attending this activity, you are not eligible to receive credit for the online version, but you are welcome to use it as a resource in your practice.

RELEASE DATE: October 13, 2011      EXPIRATION DATE: October 12, 2012

MEDIA:

Video/slides with interactive questions. Printable PDF also available.

TARGET AUDIENCE:

Physicians, NPs, PAs, clinical pharmacists, and other clinicians who practice in psychiatry and primary care who are involved in diagnosing and treating patients with complicated depression.

STATEMENT OF NEED:

SUCCEED will use case studies and video vignettes to explore practical issues in the accurate diagnosis and evidence-based management of complicated depressive disorders, including Major Depressive Disorder (MDD) and bipolar depression. Depressive symptoms, as a result of unipolar or bipolar illness, continue to profoundly impact U.S. adults.^1,2 Although depressive symptoms are similar in various conditions (persistent sad feelings, feelings of hopelessness, irritability, sleep/appetite changes), their clinical presentation, comorbidities, treatment, and outcomes may differ depending on the cause.

The importance of achieving remission cannot be overstated when treating complicated depression. Those who achieve symptomatic remission experience greater improvement in functioning (and commensurate improvement in disability) than those who obtain some response without full remission.³ Treating only to "response" leaves the patient with residual symptoms and can lead to a greater risk for relapse and recurrence, more chronic depressive episodes, a shorter duration between episodes, and continued impairment in work and relationships.⁴

Bipolar depression may be misdiagnosed as unipolar depression if the patient is introduced to the health care system during a depressive cycle. Accurate history taking, including use of tools to assess for previous manic or hypomanic episodes, can improve diagnostic accuracy and treatment response.⁵ Accurate diagnosis involves obtaining patient history of depressive symptoms and features, family psychiatric history, course of illness and treatment response. Tools such as the Mood Disorder Questionnaire (MDQ) and the World Health Organization Composite International Diagnostic Interview (CIDI) 3.0 may assist the clinician in screening for bipolarity and will be employed in this training.⁶

Differentiating bipolar from unipolar depression is critical due to the considerable length of time patients may suffer with depressive symptoms and the dramatic suicide risk that may be as much as 37-fold higher during this phase of illness.⁷

Join us to review engaging videos and to discuss detailed, case examples of how to best implement evidence-based strategies into clinical plans in order to optimize overall care of these patients.

1. Kessler RC, et al. Arch Gen Psychiatry. 2005; 2. U.S. Census Bureau 2005; 3. Trivedi MH, et al. Int Clin Psychopharmacol. 2009; 4. Judd LL, et al. Am J Psychiatry. 2000; 5. Muzina DJ, et al. Ann Clin Psychiatry. 2007; 6. Manning JS. Prim Care Companion J Clin Psychiatry. 2010; 7. Valtonen HM, et al. Bipolar Disord. 2008.

LEARNING OBJECTIVES:

At the conclusion of this application-based activity, participants should be able to:

• Identify barriers to remission in complicated mood disorders.
• Evaluate available evidence for pharmacologic treatment of major depressive disorder and bipolar depression.
• Formulate evidence-based treatment strategies for bipolar depression and complicated unipolar depression that does not respond to first-line therapies.

AGENDA:

5 minutes           Welcome & Introductions
45 minutes         SUCCEED: Successful Strategies for Complicated Depression
                          Interactive presentation with multimedia, case studies
5 minutes            Pre-recorded Faculty Q/A
5 minutes            Posttest/Evaluation

FACULTY INFORMATION & DISCLOSURES

Roger S. McIntyre, MD, FRCPC
Head, Mood Disorders Psychopharmacology Unit
University Health Network
Associate Professor of Psychiatry & Pharmacology
University of Toronto
Toronto, ON

Dr. McIntyre has disclosed that he is a member of the speakers' bureaus for AstraZeneca, Biovail, Eli Lilly, Ortho-McNeil-Janssen, Lundbeck, and Wyeth. He receives grant/research support from Eli Lilly, Janssen, and Shire.

The planners and managers have no financial or other relationship to products or devices with commercial interests related to the content of this CE/CME activity.

INSTRUCTIONS:

To receive a statement of credit, you must:

• Review the full content of the activity
• Complete the questions within the activity
• Complete the evaluation at the end of the activity.

ACCREDITATION:

Pharmacy
Creative Educational Concepts, Inc. (CEC) is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This knowledge-based activity has been assigned ACPE # 0245-0000-11-011-H01-P and will award 1.0 contact hour (0.10 CEUs) of continuing pharmacy education credit. CEC complies with the Criteria for Quality for continuing education programming.

Statements of credit will be issued immediately online upon successful completion of the activity and evaluation.

FEE:

This activity is complimentary.

DISCLOSURE DECLARATION:

It is the policy of CEC to ensure independence, balance, objectivity, scientific rigor, and integrity in their continuing education activities.

Those involved in the development of this continuing education activity have made all reasonable efforts to ensure that information contained herein is accurate in accordance with the latest available scientific knowledge at the time of accreditation of this continuing education activity. Information regarding drugs (e.g., their administration, dosages, contraindications, adverse reactions, interactions, special warnings, and precautions) and drug delivery systems is subject to change, however, and the reader is advised to check the manufacturer's package insert for information concerning recommended dosage and potential problems or cautions prior to dispensing or administering the drug or using the drug delivery systems.

Fair balance is achieved through ongoing and thorough review of all presentation materials produced by faculty, and all educational and advertising materials produced by supporting organizations, prior to educational offerings. Approval of credit for this continuing education activity does not imply endorsement by CEC for any product or manufacturer identified.

UNLABELED USE DISCLOSURE:

This activity may include discussions of products or devices that are not currently approved for use by the Food and Drug Administration (FDA), or are currently investigational.

REQUIRED COMPUTER HARDWARE/SOFTWARE:
Windows®

• Intel Pentium ll 450MHz or faster processor (or equivalent)
• 128MB of RAM
• Microsoft Windows 98, Windows Me, Windows 2000, Windows XP, Windows Server 2003
• Microsoft Internet Explorer 5.5, Firefox l.x, Mozilla l.x, Netscape 7.x or later, AOL 9, Opera 7.11 or later

Macintosh

• PowerPC G3 SOOMI-Iz or faster processor
• 128MB of RAM 4 4
• Mac OS X v.l0.l.x, l0.2.x, l0.3.x, or l0.4.x
• Internet Explorer 5.2, Firefox 1.x, Mozilla l.x, Netscape 7.x or later, AOL for Mac OS X, Opera 6, Safari l.x` or later

  I confirm that I have read all of the above information regarding this activity.