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Bipolar Disorder - A Focus on Depression

neuroscienceCME Live and On Demand

Premiere Date: Wednesday, March 20, 2013

This activity offers CE credit for:

  1. Physicians (CME)
  2. Nurses (CNE)
  3. Certified Case Managers (CCMC)
  4. Pharmacists (ACPE)
  5. Other


All other clinicians will receive a Certificate of Attendance stating this activity was certified for AMA PRA Category 1 Credit™

Credit Expiration Date:
Thursday, March 20, 2014
Note: Credit Is No Longer Available

Faculty


Charles B. Nemeroff, MD, PhDCharles B. Nemeroff, MD, PhD (Moderator)
Professor and Chair
Department of Psychiatry
Mulva Clinic for the Neurosciences
Director, Institute of Early Life Adversity Research
Dell Medical School
The University of Texas at Austin
Austin, TX

Andrew A. Nierenberg, MDAndrew A. Nierenberg, MD 
Professor of Psychiatry
Harvard Medical School
Director of the Bipolar Research Program
Associate Director, Depression Clinical and Research Program
Massachusetts General Hospital
Boston, MA

Michael E. Thase, MDMichael E. Thase, MD 
Professor of Psychiatry
Chief, Division of Mood and Anxiety Disordes Treatment & Research
Perelman School of Medicine
University of Pennsylvania
Philadelphia, PA

Statement of Need

A great challenge in modern psychiatry and general medicine is bipolar depression (BPD), which is frequently unrecognized or incorrectly diagnosed. Greater than 40% of inpatients and outpatients diagnosed with depression are subsequently found to have bipolar disorder.(1)

Differentiating bipolar depression from unipolar depression is critical because the treatment approaches are different. Selection of the incorrect medication in BPD can have serious consequences, in which for example, misdiagnosing BPD as unipolar depression and prescribing some antidepressant agents as monotherapy can precipitate a switch into mania or hypomania.(2)

In this neuroscienceCME Live and On Demand activity, our expert faculty members will delineate the differential diagnosis of depression in BPD, illustrate how it differs from unipolar depression, and guide clinicians toward evidence-based best practices and FDA-approved recommendations that specifically target BPD management with a focus on optimizing care for each patient.


  1. Hirschfeld RM, Williams JB, Spitzer RL, et al. Development and validation of a screening instrument for bipolar spectrum disorder: the Mood Disorder Questionnaire. Am J Psychiatry. 2000;157(11):1873-1875. PMID: 11058490.
  2. Frye MA. Clinical practice. Bipolar disorder—a focus on depression. N Engl J Med. 2011;364(1):51-59. PMID: 21208108.

Continue the Discussion with neuroscienceCME Chart Reviews
Join Dr. Nemeroff to discuss complex case presentations to assist in improving the care of your patients with bipolar depression.
Bipolar Depression — Differential Diagnosis in the Community on April 24, 2013 at 12:00 PM ET. Register Now!
Bipolar Depression — Clinical Management in the Community on June 5, 2013 at 12:00 PM ET. Register Now!

Activity Goal

To educate clinicians on the application of evidence-based management and measurement-based strategies to improve the accurate diagnosis and appropriate, timely treatment of bipolar depression.

Learning Objectives

At the end of this CE activity, participants should be able to:

  • Apply general, evidence-based heuristics that can aid in differentiating patients with bipolar depression from those with unipolar depression.
  • Interpret efficacy and safety data for current and emerging therapies for bipolar depression.
  • Initiate therapy in patients with bipolar depression using an evaluation of evidence-based data, considering the impact of side effects on treatment outcomes and medication adherence.

The following learning objectives pertain only to those requesting CNE or CPE credit:

  • Review the differences between unipolar and bipolar depression.
  • Describe the various therapies that can be used to treat patient with depression from bipolar depression.
  • Explain the importance of timely treatment of bipolar depression.

Financial Support

This activity is supported by an educational grant from Sunovion Pharmaceuticals Inc.

Target Audience

Physicians, physician assistants, nurses, nurse practitioners, pharmacists, social workers, certified case managers, and other health care professionals with an interest in bipolar disorder.

Credit Information

CME Credit (Physicians):
CME Outfitters, LLC, is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

CME Outfitters, LLC, designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CNE Credit (Nurses):
Provider approved by the California Board of Registered Nursing, Provider Number CEP 15510, for 1.5 contact hours.

CCMC Credit (Certified Case Managers):
This program has been approved for 1.5 hours by the Commission for Case Manager Certification (CCMC).

CPE Credit (Pharmacists):
ACPE CME Outfitters, LLC, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. 1.5 contact hours (0.15 CEUs) Universal Activity Number: 0376-0000-13-001-H01-P (recorded programs)
Activity Type: knowledge-based

Post-tests, credit request forms, and activity evaluations must be completed online at www.neurosciencecme.com/TST750 (requires free account activation), and participants can print their certificate or statement of credit immediately (80% pass rate required). This website supports all browsers except Internet Explorer for Mac. For complete technical requirements and privacy policy, visit www.neurosciencecme.com/technical.asp.

Disclosure Declaration

It is the policy of CME Outfitters, LLC, to ensure independence, balance, objectivity, and scientific rigor and integrity in all of their CE activities. Faculty must disclose to the participants any relationships with commercial companies whose products or devices may be mentioned in faculty presentations, or with the commercial supporter of this CE activity. CME Outfitters, LLC, has evaluated, identified, and attempted to resolve any potential conflicts of interest through a rigorous content validation procedure, use of evidence-based data/research, and a multidisciplinary peer review process. The following information is for participant information only. It is not assumed that these relationships will have a negative impact on the presentations.

Dr. Nemeroff has disclosed that he receives grants/research support from the Agency for Healthcare Research and Quality (AHRQ) and the National Institutes of Health (NIH). He serves as a consultant to Allergen, Inc.; Eli Lilly and Company; SK Pharma; Roche; Takeda Pharmaceuticals North America, Inc.; and Xhale, Inc. He serves on the scientific advisory boards of the American Foundation for Suicide Prevention (AFSP); Anxiety Disorders Association of America (ADAA); CeNeRx BioPharma; National Alliance for Research on Schizophrenia and Depression (NARSAD); PharmaNeuroBoost; Xhale, Inc.; Skyland Trail; and AstraZeneca Pharmaceuticals (2009). He serves on the board of directors of the American Foundation for Suicide Prevention (AFSP); Anxiety Disorders Association of America (ADAA); Gratitude America; Cook Pharma, Inc. (2010); NovaDel Pharma, Inc; and Skyland Trail. He is a stockholder of CeNeRx BioPharma; NovaDel Pharma, Inc., PharmaNeuroBoost; Reevax Pharmaceuticals LLC; and Xhale, Inc. His other financial Interests include CeNeRx BioPharma and PharmaNeuroBoost. He holds patents for the following: method and devices for transdermal delivery of lithium (US 6,375,990B1); method of assessing antidepressant drug therapy via transport inhibition of monoamine neurotransmitters by ex vivo assay (US 7,148,027B2).

Dr. Nierenberg has received grant/research support through MGH from AHRQ; Cephalon; Forest; Mylin; NIMH; PamLabs; Pfizer Pharmaceuticals; Takeda; and Shire. In the next 2 years, it is possible that he will receive grants from Dey Pharmaceuticals; Sunovion; and Targacept. He serves as a consultant for Appliance Computing Inc. (Mindsite); Brain Cells, Inc.; Brandeis University; Bristol-Myers Squibb; Clintara; Dianippon Sumitomo (Now Sunovion); Eli Lilly and Company; EpiQ; Forest; Novartis; PamLabs; PGx Health; Shire,; Schering-Plough; Sunovion; Takeda Pharmaceuticals; Teva; and Targacept. He has consulted through the MGH Clinical Trials Network and Institute (CTNI): AstraZeneca; Brain Cells, Inc; Dianippon Sumitomo/Sepracor; Johnson and Johnson; Labopharm; Merck; Methylation Science; Novartis; PGx Health; Shire; Schering-Plough; Targacept; and Takeda/Lundbeck Pharmaceuticals. Dr. Nierenberg owns stock options in Appliance Computing, Inc. and Brain Cells, Inc. Additional income is possible from Infomedic.com depending on overall revenues of the company but no revenue has been received to date. Dr. Nierenberg received honoraria or travel expenses including CME activities from: APSARD; Belvoir Publishing; Boston Center for the Arts; University of Texas Southwestern Dallas; Hillside Hospital; American Drug Utilization Review; American Society for Clinical Psychopharmacology; Bayamon Region Psychiatric Society, San Juan, PR; Baystate Medical Center; Canadian Psychiatric Association; Columbia University; Douglas Hospital/McGill University; IMEDEX; International Society for Bipolar Disorders; Israel Society for Biological Psychiatry; John Hopkins University; MJ Consulting; New York State; Massachusetts Association of College Counselors; Medscape; MBL Publishing; Physicians Postgraduate Press; Ryan Licht Sang Foundation; Slack Publishing; SUNY Buffalo, University of Florida; University of Miami; University of Wisconsin; University of Pisa; and SciMed. Dr. Nierenberg is a presenter for the Massachusetts General Hospital Psychiatry Academy (MGHPA). The education programs conducted by the MGHPA were supported through Independent Medical Education (IME) grants from the following pharmaceutical companies in 2008: AstraZeneca, Eli Lilly, and Janssen Pharmaceuticals; in 2009 AstraZeneca, Eli Lilly, and Bristol-Myers Squibb.

Dr. Thase has disclosed that he has received research grants from Agency for Healthcare Research and Quality; Eli Lilly and Company; Forest Pharmaceuticals, Inc.; National Institute of Mental Health; and Otsuka America Pharmaceutical, Inc. He serves as a consultant for Alkermes, Inc.; AstraZeneca; Bristol-Myers Squibb Company; Eli Lilly and Company.; Dey Pharma, L.P.; Forest Pharmaceuticals, Inc.; Gerson Lehrman Group, Inc.; Guidepoint Global; H. Lundbeck A/S; MedAvante, Inc.; Merck & Co., Inc.(formerly Schering Plough and Organon); Neuronetics; Otsuka America Pharmaceutical, Inc.; Ortho-McNeil-Janssen Pharmaceuticals, Inc. (Johnson & Johnson); Pamlab, LLC; Pfizer Inc. (formerly Wyeth Ayerst Pharmaceuticals); PGxHealth, Inc; Shire US Inc..; Supernus Pharmaceuticals, Inc.; Takeda Pharmaceuticals North America, Inc.; and Transcept Pharmaceuticals , Inc. He has equity holdings in MedAvante, Inc. and received royalties from American Psychiatric Foundation; Guilford Publications; Herald Publishing House; and W.W. Norton & Company, Inc.

Tony Graham, MD (content/peer reviewer) has no disclosures to report.

Ruth Cody, BSN, RN-BC (content/peer reviewer) has no disclosures to report.

Robert Kennedy (planning committee) has no disclosures to report.

Joy Bartnett Leffler, MLA, NASW, CSE (planning committee) has no disclosures to report.

Sandra Haas Binford, MAEd (planning committee) has no disclosures to report.

Sharon Tordoff, CCMEP (planning committee) has no disclosures to report.

Unlabeled Use Disclosure

Faculty of this CE activity may include discussions of products or devices that are not currently labeled for use by the FDA. The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses (any uses not approved by the FDA) of products or devices.

CME Outfitters, LLC, the faculty, and Sunovion Pharmaceuticals Inc. do not endorse the use of any product outside of the FDA labeled indications. Medical professionals should not utilize the procedures, products, or diagnosis techniques discussed during this activity without evaluation of their patient for contraindications or dangers of use.

Questions about this activity? Call us at 877.CME.PROS (877.263.7767).

TV-078-032013-23

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