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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.
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.
Target Audience
Psychiatrist, Physician, Physician Assistant, Pharmacist, Nurse/Nurse Practitioner
Estimated Duration
Estimated Duration: 1.0 hour
Program Start Date: July 30, 2025
Program End Date: July 30, 2025
Instructional Level
Intermediate
How to Earn Credit
Participants who wish to earn AMA PRA Category 1 Credit™ or a certificate of participation may do so by completing all sections of the course, including the evaluation. After evaluating the program, course participants will be provided with an opportunity to claim hours of participation and print an official CME certificate (physicians) or certificate of participation (non-physicians) showing the completion date and hours earned.
Continuing Education Credit
Physicians
The American Psychiatric Association (APA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The APA designates this enduring event for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
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
Faculty and Planner Disclosures
Instructor
- 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).
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)
Accessibility for Participants with Disabilities
The American Psychiatric Association is committed to ensuring accessibility of its website to people with disabilities. If you have trouble accessing any of APA’s online resources, please contact us at 202-559-3900 for assistance.
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 Flash, 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
For assistance: Contact educme@psych.org for questions about this activity | Contact support@smicaladviser.org for technical assistance