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Incomplete Response in Late-Life Depression: Getting to Remission

Dr. Charles Reynolds discusses his findings of the benefits and risks of augmenting an antidepressant with an atypical antisychotic in older adults with depression.

Educational objectives:

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

  • Specify the benefits and risks of aripiprazole as an augmentation pharmacotherapy for treatment-resistant depression in older adults.
  • Compare adverse drug effects of antipsychotic medications in older adults.
  • Identify a moderator and a general prognostic factor for the effects of aripiprazole augmentation pharmacotherapy in treatment resistant late life depression.

Reading Resources:

  1. Lenze EJ, Mulsant BH, Blumberger DM, Karp JF, Newcomer JW, Anderson SJ, Dew MA, Butters MA, Stack JA, Begley AE, Reynolds CF III: Efficacy, safety, and tolerability of augmentation pharmacotherapy with aripiprazole for treatment-resistant depression in late life: A randomized placebo-controlled trial.  Lancet, 2015, online
  2. Cooper C, Katona C, Lyketsos K, Blazer D, Brodaty H, Rabins P, de Mendonça Lima CA, Livingston G:  A Systematic Review of Treatments for Refractory Depression in Older People. American Journal of Psychiatry 2011 168:7, 681-688.
  3. Maust DT, Oslin DW, Thase ME. Going Beyond Antidepressant Monotherapy for Incomplete Response in Non-Psychotic Late-Life Depression: A Critical Review.  American Journal Of Geriatric Psychiatry, 2013;21(10)
  4. Nelson, J. C., K. Delucchi and L. S. Schneider:  Efficacy of second generation antidepressants in late-life depression: a meta-analysis of the evidence." Am J Geriatr Psychiatry, 2008 16(7): 558-567
  5. Pinquart M, Duberstein PR, Lyness JM:  Treatments for Later-Life Depressive Conditions: A MetaAnalytic Comparison of Pharmacotherapy and Psychotherapy. American Journal of Psychiatry, 2006 163(9):1493-1501
  6. Pinquart M, Duberstein PR: Treatment of anxiety disorders in older adults: a meta-analytic comparison of behavioral and pharmacological interventions.  American Journal of Geriatric Psychiatry, 2007 15(8):639-651
  7. Sacks O:  The Joy of Old Age. (No Kidding.) New York Times, July 6, 2013

Disclosures:

Dr. Charles F. Reynolds III has financial interests with the following proprietary entity or entities producing health care goods or services as indicated below:

  • American Journal Geriatric Psychiatry, Editor-in-Chief
  • Board Membership - American Association of Geriatric Psychiatry, Editorial Review Board Fee
  • Extramural Support (past three years to current)
    • National Institute of Health (NIH)
    • National Institute of Mental Health (NIMH)
    • National Institute on Aging (NIA)
    • National Center for Minority Health Disparities (NIMHD) 
    • National Heart Lung and Blood Institute (NHLBI)
  • Center for Medicare and Medicaid Services (CMS)
  • Patient Centered Outcomes Research Institute (PCORI)
  • John A. Hartford Foundation
  • American Foundation for Suicide Prevention
  • Commonwealth of Pennsylvania?Clinical and Translational Science Institute (CTSI)
  • National Palliative Care Research Center (NPCRC)
  • American Association for Geriatric Psychiatry (for services as associate editor)
  • UPMC Endowment in Geriatric Psychiatry (which supports the endowed professorship)
  • Pharmaceutical Support -Bristol Meyers Squibb, Forrest Labs, Lily, Pfizer provide pharmaceutical supplies for NIH- sponsored work. (The pharmaceutical companies play no role in the design, analysis, or reporting of my data in peer reviewed journals.)
  • Honorarium - Medscape/WEB MD speaker honorarium (October 2013
  • Licensed Intellectual Property (co-inventor) -Psychometric analysis of the Pittsburgh Sleep Quality Index (PSQI), PRO10050447 (PI: Dr. Daniel Buysse)
  • For manuscripts...Supported by the National Institutes of Health through Grant Numbers P60 MD000207; P30 MH090333; UL1RR024153, UL1TR000005; and the UPMC Endowment in Geriatric Psychiatry

All presenters disclosure of relevant financial relationships with any proprietary entity producing, marketing, re-selling, or distributing health care goods or services, used on, or consumed by, patients is listed above.  No other planners, members of the planning committee, speakers, presenters, authors, content reviewers and/or anyone else in a position to control the content of this education activity have relevant financial relationships to disclose.

Accreditation Statement:

The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Pittsburgh School of Medicine designates this enduring material for a maximum of .5 AMA PRA Category 1 Credits™. Each physician should only claim credit commensurate with the extent of their participation in the activity. Other health care professionals are awarded (.05) continuing education units (CEU) which are equivalent to .5 contact hour.

For your credit transcript, please access our website 4 weeks post-completion at http://ccehs.upmc.edu and follow the link to the Credit Transcript page. If you do not provide the last 5 digits of your SSN on the next page you will not be able to access a CME credit transcript. Providing your SSN is voluntary. 

Release Date: 10/6/2016 | Last Modified On: 10/6/2016 | Expires: 10/6/2017

TRANSCRIPT

Presenter

Charles F. Reynolds III, MD

Charles F. Reynolds III, MD Charles F. Reynolds III, MD, is distinguished professor of psychiatry, neurology, behavioral and community Sciences, and clinical and translational science, and UPMC endowed professor in geriatric psychiatry. He is director of the Aging Institute of UPMC Senior Services and University of ...
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