Support Statement

Supported by an educational grant from Takeda Pharmaceuticals U.S.A., Inc. and Lundbeck.

Learning Objectives

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

• Consider how current antidepressants’ mechanisms of action fit the supposed etiology of depression, including patients’ possible biological differences
• Consider whether mechanisms of action of emerging MDD treatments could affect MDD treatment outcomes
• Address suicide risk factors and medical/psychiatric comorbidities among patients with MDD
• Adjust the course of MDD treatment using ongoing evaluations of residual symptomatology, comorbidities, suicide risk, functioning, adherence, and side effect severity

Release, Review, and Expiration Dates

This audio summary activity was published in July 2019 and is eligible for AMA PRA Category 1 Credit™ through July 31, 2021. The latest review of this material was June 2019.

Statement of Need and Purpose

Despite the availability of many antidepressants, people with major depressive disorder (MDD) have unmet treatment needs. Patients treated for MDD often experience lack of response or delayed efficacy, side effects that cause them to discontinue their medications, and residual symptoms that interfere with functioning. Contributing factors to the continued burden and poor outcomes of MDD include clinicians’ failures to (1) consider biological differences among people with MDD that affect the way they respond to different treatment options, (2) identify how medications with novel mechanisms of action (MOAs) may serve the needs of some individuals better than others, and (3) measure whether a treatment plan is working. Additionally, although MDD is a life-threatening disease, clinicians often fail to recognize patients at high risk for suicide and patients with comorbidities that can increase mortality risk if left unaddressed. Antidepressants with novel MOAs, quicker onset, and fewer safety and side effect issues have the potential to improve outcomes for patients with MDD; thus, clinicians must become familiar with their therapeutic profiles, MOAs, and how to effectively use them to help patients achieve remission. This activity was designed to meet the needs of participants in CME activities provided by the CME Institute of Physicians Postgraduate Press, Inc., who have requested information on MDD.

Disclosure of Off-Label Usage

The faculty members have determined that, to the best of their knowledge, ketamine, naltrexone, buprenorphine, samidorphan, hydroxynorketamine, midazolam, rapastinel, D-cyloserine, riluzole, memantine, lanicemine, traxoprodil, MK-0657, asenapine, ziprasidone, pimavanserin, risperidone, lurasidone, clozapine, and ezogabine are not approved by the US Food and Drug Administration for the treatment of major depressive disorder (MDD); brexpiprazole, olanzapine, aripiprazole, and quetiapine are not approved as monotherapy for MDD; esketamine is not approved for the treatment of bipolar depression; and neuropeptide Y is not approved for the treatment of posttraumatic stress disorder.

Review Process

The faculty members agreed to provide a balanced and evidence-based presentation and discussed the topics and CME objectives during the planning sessions. The faculty’s submitted content was validated by CME Institute staff, and the activity was evaluated for accuracy, use of evidence, and fair balance by the chair and a peer reviewer who is without conflict of interest.

Acknowledgment

This Audio Summary was derived from the ASCP presentation “New Mechanisms, New Opportunities: Integrating Novel Antidepressants in the Treatment of Major Depressive Disorder,” which was held in May 2019, and was supported by an educational grant from Takeda Pharmaceuticals U.S.A., Inc. and Lundbeck. The opinions expressed herein are those of the faculty and do not necessarily reflect the opinions of the CME provider and publisher or the commercial supporter.