Description
People who experience a major depressive episode have at least a 50% chance of having one more episode during their lifetime. If they have had three or more episodes, then they have a 90% chance of another episode. Fortunately, maintenance treatment with antidepressants can lower the risk substantially and have been found superior to placebo substitution in almost all of the long-term studies. Nevertheless, questions remain: should one take an antidepressant forever? What are the risks of long-term antidepressant treatment? Can people take drug holidays (periods of time without antidepressants)? If someone had a difficult to treat depression which responded to a combination of an antidepressant and antipsychotic, should they continue to take both medications? What happens if someone is taking long-term antidepressant treatment and then they have another depressive episode? What is the role of psychotherapy in preventing another episode? Can people stop their medication if psychotherapy seems to work? This webinar will address these questions and review the data so that participants can make informed decisions about long-term antidepressant treatment.
Format
Recorded webinar, non-interactive, self-paced distance learning activity with post-test.
This presentation was recorded on March 26, 2020.
Learning Objectives
Assess the risk of recurrent major depressive episodes.
Summarize the strengths and weaknesses of long-term antidepressant treatment.
Describe the strengths and weaknesses of psychotherapy alone to prevent recurrent depressive episodes.
Outline
- Understanding Depression Relapse and Recurrence
- Efficacy of Long-Term Antidepressant Use
- Alternative and Adjunctive Treatments
- Guidelines for Maintenance Treatment
- Clinical Implications and Future Directions
Target Audience
Psychiatrist, Physician (Non-Psychiatric), Physician Assistant, Nurse Practitioner, Nurse, Pharmacist
Instruction Level
Advanced
Estimated Time to Complete
Estimated Duration: 1.0 hour
Program Start Date: July 30, 2025
Program End Date: March 26, 2026
Program Review Date: January 4, 2023
Ongoing Interdisciplinary Discussion Board
After completing the course, engage with colleagues in the mental health field through the Webinar Roundtable Topics discussion board. This is an easy way to network and share ideas with other clinicians who participate in this webinar. Access through the discussion tab.
How to Earn Credit
After completing the evaluation, participants will have the opportunity to claim their hours of participation and download the appropriate certificate. Physicians may obtain an official CME certificate, other healthcare professionals may receive a CE certificate (as applicable), and all other attendees may generate a certificate of participation. Each certificate will reflect the event date and total hours earned.
Continuing Education Credit
In support of improving patient care, American Psychiatric Association (APA) is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physicians
The APA designates this live event for a maximum of 1.00 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Faculty and Planner Disclosures
The American Psychiatric Association adheres to the ACCME's Standards for Integrity and Independence in Accredited Medical Education. Any individuals in a position to control the content of a CME activity - including faculty, planners, reviewers, or others - are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.
Faculty
- Andrew Nierenberg, MD, Massachusetts General Hospital. Disclosures - Consultant: Alkermes, Jazz Pharmaceuticals, Sage Pharmaceuticals, Otsuka, Neuronetics, Acadia Pharmaceuticals, Esai, Myriad; Grant/Research: American Foundation for Suicide Prevention, AHRQ, Brain and Behavior Research Foundation, Patient Centered Outcomes Research Institute (PCORI).
Program Planners
- Teri Brister, PhD, LPC, National Alliance on Mental Illness. Reports no financial relationships with commercial interests.
- Tristan Gorrindo, MD, American Psychiatric Association. Reports no financial relationships with commercial interests.
Reviewers
- John Torous, MD, Beth Israel Deaconess Medical Center. Dr. Torous has no relevant financial relationships to disclose. (Reviewed on 1/4/23)
- Teri Brister, PhD, LPC, National Alliance on Mental Illness. Dr. Brister has no relevant financial relationships to disclose. (Reviewed on 1/4/23)
References
- DeRubeis et al., Prevention of Recurrence after Recovery from a Major Depressive Episode with Antidepressant Medication Alone or in Combination with Cognitive Behavioral Therapy: A Phase 2 Randomized Clinical Trial. JAMA Psychiatry. Doi: 10.1001/jamapsychiatry.2019.3900
- Cipriani, A., Furukawa, T. A., Salanti, G., Chaimani, A., Atkinson, L. Z., Ogawa, Y., … Geddes, J. R. (2018). Comparative Efficacy and Acceptability of 21 Antidepressant Drugs for the Acute Treatment of Adults With Major Depressive Disorder: A Systematic Review and Network Meta-Analysis. The Lancet, 391(10128), 1357–1366. doi: 10.1176/appi.focus.1640
- Salloum et al., Time to Relapse After a Single Administration of Intravenous Ketamine Augmentation in Unipolar Treatment-Resistant Depression. Journal of Affective Disorders. 2020 Jan 1; 260: 131-139. Doi: 10.10.16/j.jad.2019.09.017
Accessibility for Participants with Disabilities
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Technical Requirements
This internet-based CME activity is best experienced using any of the following:
The latest and 2nd latest public versions of Google Chrome, Mozilla Firefox, or Safari
Internet Explorer 11+
This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Acrobat Reader, Microsoft PowerPoint, and Windows Media Player.
Optimal System Configuration:
Browser: Google Chrome (latest and 2nd latest version), Safari (latest and 2nd latest version), Internet Explorer 11.0+, Firefox (latest and 2nd latest version), or Microsoft Edge (latest and 2nd latest version)
Operating System: Windows versions 8.1+, Mac OS X 10.5 (Leopard) +, Android (latest and 2nd latest version), or iOS/iPad OS (latest and 2nd latest version)
Internet Connection: 1 Mbps or higher
Minimum Requirements:
Windows PC: Windows 8.1 or higher; 1 GB (for 32-bit)/2 GB (for 64-bit) or higher RAM; Microsoft DirectX 9 graphics device with WDDM driver; audio playback with speakers for programs with video content
Macintosh: Mac OS X 10.5 or higher with latest updates installed; Intel, PowerPC G5, or PowerPC G4 (867MHz or faster) processor; 512 MB or higher RAM; audio playback with speakers for programs with video content
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