COURSE DESCRIPTION:
Most patients with major depressive disorder fail to respond completely to initial treatment with an antidepressant. In addition, at least 10-20% of patients do not respond adequately to multiple medication trials and psychotherapy. Even a robust response to treatment with some residual symptoms is associated with a poorer long term outcome. The NIMH funded STAR*D trial has provided a number of insights and about treatment resistant depression. In this lecture, we will review the finding of this STAR*D study and its implications for clinical practice. In addition, the use of devices for the treatment of resistant depression will be discussed.
PRESENTER BIO
Charles DeBattista, M.D., D.M.H.
 Dr. Charles DeBattista received his M.D. from University of California San Francisco in l989, where he had previously received his Doctorate in Mental Health. He is the Associate Professor of Psychiatry at Stanford University School of Medicine and has been honored multiple times as “Teacher of the Year”. In addition to teaching, Dr. DeBattista is actively engaged in clinical practice, as he serves as the Director of the Depression Research Clinic and Director of the outpatient Depression and Psychopharmacology Clinics.
Dr. DeBattista’s research interests include the pharmacotherapy of severe and resistant depression. He is the winner of multiple prestigious research awards including the NARSAD young Investigator’s Award and a NIMH New Investigator Award. He is the assistant editor of the Journal of Psychiatric Research and has numerous publications including the Medical Management of Depression in 2002 (3rd edition), and the 2005 Black Book of Psychotropic Dosing and Monitoring (with Alan Schatzberg).
COURSE OBJECTIVES:
Participants will be able to identify:
- The implications of failing to treat patients to remission.
- The implications of the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) Trial for treating resistant depression.
- The role of devices for resistant depression including ECT, vagus nerve stimulation (VNS), transcranial magnetic stimulation (TMS) and deep brain stimulation (DBS).
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OUTLINE AND SCHEDULE:
- Introduction (2 minutes)
- Financial Disclosures (1 minute)
- Course Overview and Agenda (2 minutes)
- Prevalence of treatment resistant depression (3 minutes)
- Risks for patients who fail to respond to treatment (10 minutes)
- Management and treatment issues (15 minutes)
- Remission rates in the STAR* D trial (10 minutes)
- Adjunctive treatments for resistant depression (10 minutes)
- Summary (5 minutes)
- Questions and Answers (15 minutes)
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