Improving Diagnosis & Treatment Strategies
for Major Depressive Disorder

A continuing medical education activity sponsored by NAMCP and AAMCN.

This activity is an archive from the live session at the 2017 Spring Forum. If you participated in the live session, you are not eligible for continuing education credits from this archive.

This activity is valid from June 25, 2017 to August 1, 2018

Instructions for CME/CNE: Complete the pre test, listen to the audio and view the slides, complete the post test, complete the evaluation form and hit submit. If you close your internet browser without completing the post test, you will have ONE more opportunity to complete. A score of 70% must be achieved on the post test to receive continuing education credits. If you do not pass the post test after two attempts, you will not be eligible to try again. Once you complete the evaluation form and score 70% or higher on your post test, you will automatically be given your certificate.

To print or save your certificate, you will need to click on the “download” button and either print or save.


Audience: This activity is intended for healthcare professionals practicing in managed care environments.

This educational activity is supported by educational grants from
Takeda Pharmaceuticals USA Inc and Lundbeck

Major depression is a treatable cause of pain, suffering, disability and death, yet primary care clinicians detect major depression in only one-third to one-half of their patients with major depression. In 2010, The World Health Organization (WHO) released date from their study of depression and mental disorders in the United States and found that MDD accounts for 8.31 percent of US years lived with disability (YLDs). YLDs are the prevalence of MDD times the short- or long-term loss of health. To help put this in perspective, anxiety disorders, the second highest YLDs, account for 5.09%, with drug use disorders accounting for 3.53%. MDD also accounts for 3.7 percent of all US disability-adjusted life years (DALYs), that being the total number of years lost to illness, disability, or premature death. While drug use disorders account for 2.61% and anxiety disorders account for 2.28%. Comorbidities or complications that may arise from MDD include alcohol abuse or substance abuse, stroke, type 2 diabetes, isolation, work and personal conflicts, and an increased chance of suicide.

Major depression disorder can be effectively treated and allow the patient to live without debilitating depression. Newer antidepressant medications have been shown to effectively decrease the symptoms of MDD. Treatment is based on severity of depression, and episode types. Treatment may be multi-faceted, combining medication with psychotherapy. Treatment may change several times as different medications affect people in different ways. Treatment may start with a selective serotonin reuptake inhibitor (SSRI), but if there is no effect, or if the side effects are adverse enough to affect patient adherence, then treatment may change to a serotonin and norepinephrine reuptake inhibitor (SNRI) or a norepinephrine and dopamine reuptake inhibitor (NDRI). Some effective treatments, specifically antidepressants, are currently limited by factors that affect treatment adherence and bring about different side-effects. Recent data showing antidepressant combinations with different mechanisms of action can be a better strategy prior to augmentation with other drug classes. Combination therapies, including multiple pharmacological actions, can affect multiple monoamine targets which can produce greater efficacy.

Upon Completion of this activity, participants will be able to:

  • Review the importance of appropriate diagnosis and screening of depression as well as the risk it can cause patients

  • Assess current evidence for efficacy and safety of new therapies recently approved for the treatment of depression

  • Discuss the current and novel treatments for patients who are not responding adequately to first line therapies

  • Explore proper communication strategies for patients to address adherence, side effects, and ways to improve outcomes

Faculty: Leslie Citrome, MD, MPH
Clinical Professor of Psychiatry and Behavioral Sciences
New York Medical College


Dr. Citrome is on the speakers bureau for Acadia, Alkermes, Allergan, AstraZeneca, Janssen, Jazz, Lundbeck, Merck, Novartis, Otsuka, Pfizer, Shire, Sunovion, Takeda and Teva. He also serves as a consultant to Acadia, Alezza, Alkermes, Allergan, Boehringer Ingelheim, Bristol-Myers Squibb, Genentech, ITI, Janssen, Jazz, Lilly, Lundbeck, Merck, Medivation, Mylan, Neurocrine, Novartis, Noven, Otsuka, Pfizer, Reckitt Benckiser, Reviva, Shire, Sunovion, Takeda, Teva, Valeant and Vanda.
Dr. Citrome purchased common stock over 10 years ago in Bristol Myers Squibb, Johnson & Johnson, Lilly, Merck and Pfizer. His presentation has been peer reviewed.
  Planning Committee:
Bill Williams, MD has no real or perceived financial relationships to disclose.
Will Williams has no real or perceived financial relationships to disclose.
Katie Eads has no real or perceived financial relationships to disclose.
Jacquelyn Smith has no real or perceived financial relationships to disclose.

NAMCP and/or the presenter has copyright or has received permissions for use of materials provided in this activity.

Accreditation & Designation

The National Association of Managed Care Physicians (NAMCP) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

NAMCP designates this enduring material for a maximum of 1 AMA PRA Category I creditsTM. Each physician should claim credit commensurate with the extent of their participation in the activity.

The American Association of Managed Care Nurses is accredited as a provider of continuing nursing
education by the American Nurses Credentialing Center’s Commission on Accreditation.

Nurses who complete this activity and achieve a passing score will receive 1 hour in continuing
nursing credit.

This activity has been approved by the American Board of Managed Care Nursing for 1.0 contact hours toward CMCN recertification requirements.

This educational activity is supported by educational grants from
Takeda Pharmaceuticals USA Inc and Lundbeck

NAMCP and/or this website does not provide medical advice, diagnosis or treatment. NAMCP does not endorse or imply endorsement of the content on any linked website. This website is to be used as an informational resource. With any health related concern, consult with your physician or healthcare professional.

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