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Setting the Bar High: Achieving and Maintaining Remission in Patients with Major Depressive Disorder

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neuroscienceCME Live and On Demand

Premiere Date: Wednesday, October 26, 2011

This activity offers CE credit for:

  1. Physicians (CME)
  2. Nurses (CNE)
  3. Psychologists (APA)
  4. Social Workers (NASW)
  5. Certified Case Managers (CCMC)
  6. Pharmacists (ACPE)


All other clinicians will receive a Certificate of Attendance stating this activity was certified for AMA PRA Category 1 Credit™

Credit Expiration Date:
Friday, October 26, 2012
Note: Credit Is No Longer Available

Faculty


Michael E. Thase, MDMichael E. Thase, MD (Moderator)
Professor of Psychiatry
Department of Psychiatry
Perelman School of Medicine at the University of Pennsylvania
Corporal Michael J. Crescenz Veterans Affairs Medical Center
Philadelphia, PA

Linda L. Carpenter, MDLinda L. Carpenter, MD 
Chief, Mood Disorders Program
Butler Hospital
Associate Professor
Brown Department of Psychiatry and Human Behavior
Providence, RI

Madhukar H. Trivedi, MDMadhukar H. Trivedi, MD 
Professor of Psychiatry
Betty Jo Hay Distinguished Chair in Mental Health
University of Texas Southwestern Medical Center
Dallas, TX

Statement of Need

For patients with major depressive disorder (MDD), durable remission - both in terms of symptom control and functional ability - is the penultimate therapeutic goal.(1) Striving for attainment of this goal is paramount. It means that clinicians must be outfitted with tools and strategies and must know how to use them in a manner that balances optimal efficacy with safety and tolerability.

This neuroscienceCME Live and On Demand activity addresses clinician-based gaps related to underachievement of sustained remission in patients with MDD.(2) Specifically, the panel of expert faculty will discuss selection of initial monotherapy based on pharmacologic profiles of agents and patient characteristics; assisting patients in harnessing the power of psychotherapy; improving routine, systematic assessment of clinical response; and employing strategies (e.g., augmentation) when initial therapies fail.


  1. Gelenberg AJ, Freeman MP, Markowitz JC, et al.; for the American Psychiatric Association. Practice Guideline for the Treatment of Patients With Major Depressive Disorder. 3rd ed. American Psychiatric Association Website. http://www.psychiatryonline.com/pracGuide/pracGuideTopic_7.aspx. Published November 2010. Accessed September 12, 2011.
  2. Rush AJ, Trivedi JH, Wisniewski SR, et al. Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. Am J Psychiatry. 2006;163(11):1905-1917.

Activity Goal

Through achievement of the specified gaps-based learning objectives, clinician learners will manage major depression using evidence-based strategies that are most likely to result in durable remission.

Learning Objectives

At the end of this CE activity, participants should be able to:

  • Assess treatment response and clinical status in major depressive disorder (MDD) through routine, systematic use of measurement-based care concepts and validated rating scales.
  • Tailor individualized treatment plans for patients with MDD according to the "best fit" of patient needs and pharmacologic profiles for evidence-based treatment options.
  • Implement a strategy for treating MDD residual symptoms that optimizes pharmacotherapy and integrates psychotherapy with a goal of sustained remission.

The following learning objectives pertain only to those requesting CNE or CPE credit:

  • Describe the rationale for using validated, patient-completed rating scales to assess clinical status in major depressive disorder (MDD).
  • Identify the pharmacologic profiles for evidence-based treatment options for major depressive disorder.
  • Recognize residual symptoms of major depressive disorder that can be addressed through pharmacotherapy optimization and use of adjunctive psychotherapy.

Financial Support

Supported in part by an educational grant from AstraZeneca LP. Additional support has been provided by CME Outfitters, LLC.

Target Audience

Physicians, physician assistants, nurses, nurse practitioners, pharmacists, psychologists, social workers, certified case managers, and other health care professionals who provide outpatient mental health care and services to patients with mood disorders.

Credit Information

CME Credit (Physicians):
CME Outfitters, LLC, is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

CME Outfitters, LLC, designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credit™ Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CNE Credit (Nurses):
Provider approved by the California Board of Registered Nursing, Provider Number CEP 15510, for 1.5 contact hours.

CEP Credit (Psychologists):
CME Outfitters is approved by the American Psychological Association to sponsor continuing education for psychologists. CME Outfitters maintains responsibility for this program and its content. (1.5 CE credits)

NASW Credit (Social Workers):
This program was approved by the National Association of Social Workers (provider #886407722) for 1.5 continuing education contact hours.

CCMC Credit (Certified Case Managers):
This program has been approved for 1.5 hour by the Commission for Case Manager Certification (CCMC).

CPE Credit (Pharmacists):
ACPE CME Outfitters, LLC, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. 1.5 contact hours (0.15 CEUs)
Universal Activity Number: 0376-0000-11-020-H01-P (recorded programs)
Activity Type: knowledge-based

Post-tests, credit request forms, and activity evaluations must be completed online at www.cmeoutfitters.com/test (requires free account activation), and participants can print their certificate or statement of credit immediately (80% pass rate required). This website supports all browsers except Internet Explorer for Mac. For complete technical requirements and privacy policy, visit www.neurosciencecme.com/technical.asp.

Disclosure Declaration

It is the policy of CME Outfitters, LLC, to ensure independence, balance, objectivity, and scientific rigor and integrity in all of their CME/CE activities. Faculty must disclose to the participants any relationships with commercial companies whose products or devices may be mentioned in faculty presentations, or with the commercial supporter of this CME/CE activity. CME Outfitters, LLC, has evaluated, identified, and attempted to resolve any potential conflicts of interest through a rigorous content validation procedure, use of evidence-based data/research, and a multidisciplinary peer review process. The following information is for participant information only. It is not assumed that these relationships will have a negative impact on the presentations.

Dr. Thase has disclosed that he has received research grants from Agency for Healthcare Research and Quality; Eli Lilly and Company; Forest Pharmaceuticals, Inc.; National Institutes of Mental Health; and Otsuka America Pharmaceutical, Inc. He has made promotional presentations on behalf of AstraZeneca Pharmaceuticals, Bristol-Myers Squibb Company; Dey Pharma, L.P.; Merck & Co., Inc.; and Pfizer Inc. He serves as a consultant for Alkermes, Inc.; AstraZeneca; Bristol-Myers Squibb Company; Eli Lilly and Company.; Dey Pharma, L.P.; Forest Pharmaceuticals, Inc.; Gerson Lehrman Group, Inc.; Guidepoint Global; H. Lundbeck A/S; MedAvante, Inc.; Merck & Co., Inc.; Neuronetics; Otsuka America Pharmaceutical, Inc.; Ortho-McNeil-Janssen Pharmaceuticals, Inc.; Pamlab, LLC; Pfizer Inc.; PGxHealth, Inc; Shire US Inc..; Supernus Pharmaceuticals, Inc.; Takeda Pharmaceuticals North America, Inc.; and Transcept Pharmaceuticals , Inc. He has equity holdings in MedAvante, Inc. and received royalties from American Psychiatric Foundation; Guilford Publications; Herald Publishing House; and W.W. Norton & Company, Inc.

Dr. Carpenter has disclosed that she receives grant/research support from Cyberonics, Inc.; Medtronic, Inc.; National Institutes of Mental Health; NeoSync Inc.; and Neuronetics.She serves as a consultant to/is on the advisory boards of Abbott Laboratories; Ferring Pharmaceuticals; Helicon Therapeutics; and Neuronetics (consultancy on a volunteer basis only).Dr. Carpenter serves on the speakers bureau for Neuronetics.

Dr. Trivedi has disclosed that he receives research support from the Agency for Healthcare Research and Quality; Corcept Therapeutics, Inc.; Cyberonics, Inc.; Merck; National Alliance for Research in Schizophrenia and Depression; National Institute of Mental Health; National Institute on Drug Abuse; Naurex; Novartis Pharmaceuticals Corporation; Pharmacia & Upjohn, Inc.; Predix Pharmaceuticals; Solvay Pharmaceuticals, Inc.; Targacept; and Valient; He has received consulting and speaker fees from Abbott Laboratories; Abdi Ibrahim; Akzo Nobel (Organon International); Alkermes; AstraZeneca; Bristol-Myers Squibb Company, Cephalon, Inc.; Eli Lilly and Company; Evotec; Fabre-Kramer Pharmaceuticals, Inc.; Forest Pharmaceuticals, Inc.; GlaxoSmithKline; Janssen Pharmaceutical Products.; Johnson & Johnson Pharmaceutical Research & Development, LLC; Libby, LP; Lundbeck; Meade Johnson; Medtronic; Neuronetics Inc.; Otsuka Pharmaceuticals; Parke-Davis Pharmaceuticals, Inc.; Pfizer Inc.; PgxHealth; Rexahn Pharmaceuticals; Sepracor Inc.; SHIRE Development; Sierra; Tal Medical/Puretech; Transcept VantagePoint Venture Partners, Wyeth-Ayerst Laboratories.

Monique Johnson, MD, CCMEP (planning committee) has no disclosures to report.

Sharon Tordoff, CCMEP (planning committee) has no disclosures to report.

Unlabeled Use Disclosure

Faculty of this CME/CE activity may include discussions of products or devices that are not currently labeled for use by the FDA. The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses (any uses not approved by the FDA) of products or devices.

CME Outfitters, LLC, the faculty, and AstraZeneca LP do not endorse the use of any product outside of the FDA labeled indications. Medical professionals should not utilize the procedures, products, or diagnosis techniques discussed during this activity without evaluation of their patient for contraindications or dangers of use.

Questions about this activity? Call us at 877.CME.PROS (877.263.7767).

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