Recent Updates in the Treatment of Major Depressive Disorder: Overcoming Barriers through Personalized Care

A continuing medical education activity sponsored by NAMCP and AAMCN.

This activity is an archive from the live session from the 2020 Spring Managed Care Forum. If you participated in the live session, you are not eligible for continuing education credits from this archive

This activity is valid from May 1, 2020 to August 1, 2021

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. You will be asked to enter your name and email address on the pre-test, evaluation and post-test. 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.

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

This presentation is supported by an educational grant from
Takeda Pharmaceuticals USA, Inc. and Lundbeck

Major depression is a debilitating condition that nearly 20% of the general population in the United States will experience at some point in their life. With appropriate treatment, 70-80% of individuals with major depressive disorder can achieve a significant reduction in symptoms, although as many as 50% of patients may not respond to the initial treatment trial. In addition, more than 80% of patients with depression have a medical comorbidity. Comorbidities or complications that can come from MDD include alcohol abuse or substance abuse, type 2 diabetes, isolation, work and personal conflicts, and an increased chance of suicide. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association (APA), a diagnosis of clinical depression requires the presence of depressed mood, a loss of pleasure and interest, decreased energy, changes in sleep patterns, and feelings of worthlessness, hopelessness, or guilt for a period of at least 2 weeks. It is important to assess the overall severity of depressive symptoms because symptom severity correlates with suicide risk. A focused severity assessment for hopelessness, suicidal ideation, and psychotic symptoms is recommended; these symptoms independently increase the risk for suicide.

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. There are several treatment methods for major depression disorder. These approaches include psychotherapy, antidepressant medications, electroconvulsive treatment (ECT), and other somatic therapies. However, ECT is generally avoided, except in extreme circumstances, in favor of psychotherapy and antidepressants. Antidepressant treatments include selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, atypical and tricyclic antidepressants, monoamine oxidase inhibitors and other medications. Combination therapies, including multiple pharmacological actions, can affect multiple monoamine targets which can produce greater efficacy. While there are many options out there, the need to personalize a treatment plan for each individual patient is important as the ultimate goal of care providers is to move patients suffering from MDD to remission, then recovery, and to avoid a relapse. While this alone is a challenge for clinicians, it becomes even more difficult in patients with cardiovascular disease risk factors such as smoking, diabetes, hypertension, obesity and dyslipidemia. Further complicating matters are the risks associated with some medications used to treat depression.

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

  • Analyze the safety and efficacy for current and emerging pharmacologic treatments for patients with major depressive disorder (MDD) to inform optimal therapeutic decisions

  • Identify the risk factors and assess symptoms associated with MDD to improve accurate diagnosis

  • Describe personalized strategies that include alternate antidepressant treatments for patients that had an inadequate response to initial care

  • Examine different limitations and barriers of care to current treatments and discuss ways to overcome them

  • Assess strategies for a measurement based, shared decision-making approach for optimal treatment of major depression

Faculty: Michael E. Thase, MD
Professor of Psychiatry
Perelman School of Medicine
University of Pennsylvania


Dr. Thase serves on an advisory board for Acadia, Akili, Alkermes, and Allergan (Forest, Naurex). He has received grant/research support from Acadia, Allergan, Axsome Therapeutics, Inc., Intracellular, Johnson & Johnson (Janssen), Otsuka Pharmaceutical Company, Patient-Centered Outcomes Research Institute (PCORI), and Takeda. He has received royalties from the American Psychiatric Foundation, Guilford Publications, Herald House, and N.W. Norton & Company, Inc. His presentation has been peer reviewed for any bias.
  Planning Committee:
Bill Williams, MD has no relevant financial relationships to disclose.
Jeremy Williams has no relevant financial relationships to disclose.
Will Williams has no relevant financial relationships to disclose.
Jacqueline Cole, RN, MS, CMCN has no relevant 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
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the National Association of Managed Care Physicians (NAMCP) and American Association of Managed Care Nurses (AAMCN). The National Association of Managed Care Physicians is accredited by the ACCME to provide continuing medical education for physicians.

NAMCP designates this enduring material for a maximum of 1 AMA PRA Category 1 credit(s)TM. 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 nursing continuing professional development 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 presentation is supported by an educational grant 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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