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Remission in MDD: What Does the Future Hold for Clinicians and Patients?

Click Here To Download Faculty Response to Questions from the Live Webcast (PDF)

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neuroscienceCME Live and On Demand

Premiere Date: Wednesday, January 7, 2015

This activity offers CE credit for:

  1. Physicians (CME)
  2. Nurses (CNE)
  3. Social Workers (NASW)
  4. Certified Case Managers (CCMC)
  5. Pharmacists (ACPE)
  6. 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, January 7, 2016
Note: Credit Is No Longer Available

Faculty


Charles B. Nemeroff, MD, PhDCharles B. Nemeroff, MD, PhD (Moderator)
Leonard M. Miller Professor and Chairman
Department of Psychiatry and Behavioral Sciences
Clinical Director, Center on Aging
Chief of Psychiatry, Jackson Memorial Hospital
Chief of Psychiatry, University of Miami Hospital
Professor of Biochemistry and Molecular Biology
Leonard M. Miller School of Medicine
University of Miami
Miami, FL

Roger S. McIntyre, MD, FRCPCRoger S. McIntyre, MD, FRCPC 
Professor of Psychiatry and Pharmacology
University of Toronto
Executive Director
Brain and Cognition Discovery Foundation (BCDF)
Head, Mood Disorders Psychopharmacology Unit
University Health Network
Toronto, ON

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

Although many antidepressants are available to treat major depressive disorder (MDD), as many as 70% of patients diagnosed with MDD do not reach remission even after receiving an adequate course of treatment.1 Remission is currently being redefined. The outcome measure that is generally reported in clinical trials "has been arbitrarily defined as a symptom reduction of 50% or greater from pretreatment in total symptom severity."2 Yet, a response that does not achieve an asymptomatic remitted state "constitutes an unsatisfactory outcome in that it includes patients with ongoing, clinically significant disease activity. While symptomatic remission increases the probability for recovery in MDD. Available evidence indicates that the majority of individuals with MDD receiving guideline-concordant and measurement-based care do not achieve and sustain a fully remitted state with index antidepressant treatment.3

This neuroscienceCME Live and On Demand will challenge clinicians to reinvent the future of MDD treatment which includes increased patient participation in the treatment process, measurement-based care and a re-definition of treatment to remission as improvement of all symptoms of MDD with functional recovery.


  1. Nelson JC, Pikalov A, Berman RM. Augmentation treatment in major depressive disorder: focus on aripiprazole. Neuropsychiatr Dis Treat. 2008;4(5):937-948. PMID: 19183784.
  2. Trivedi MH, Rush AJ, Wisniewski SR, et al; STAR*D Study Team. Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D: implications for clinical practice. Am J Psychiatry. 2006;163(1):28-40. PMID:
  3. McIntyre RS, Filteau MJ, Martin L, et al. Treatment-resistant depression: definitions, review of the evidence, and algorithmic approach. J Affect Disord. 2014;156:1-7. PMID: 24314926.

Activity Goal

This educational activity centers on the CME Outfitters Make One Change statement. This statement is crafted from pertinent quality measures or clinical guidelines as a performance challenge to all participants. The Make One Change statement for this activity is:

Health care providers and patients will work together to ensure that all patients with a diagnosis of major depression are evaluated for residual symptoms or early evidence of relapse in MDD.

Learning Objectives

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

  • Assess symptom severity with a validated tool at each visit.
  • Initiate an evidence-based treatment plan that involves patient participation to address residual symptoms of depression.
  • Develop a long-term treatment plan with the patient focused on sustained remission and recovery.

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

  • Review assessment tools for major depressive disorder.
  • Define residual symptoms of depression.
  • Discuss the value of long-term remission in major depressive disorder.

Financial Support

Supported by an educational grant from Otsuka America Pharmaceutical, Inc.

Target Audience

Psychiatrists, primary care physicians, nurse practitioners, physician assistants, nurses, pharmacists, social workers, clinical case managers, and other health care professionals who share the goal of achieving remission in patients with MDD.

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.

NASW Credit (Social Workers):
This program was approved by the National Association of Social Workers (provider #886407722) for 1.5 continuing education 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: 0376-0000-15-001-L01-P (live programs)
0376-0000-15-001-H01-P (recorded programs)
Activity Type: knowledge-based

Post-tests, credit request forms, and activity evaluations must be completed online at www.cmeoutfitters.com/TST948 (requires free account activation), and participants can print their certificate or statement of credit immediately (75% 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 National Institutes of Health (NIH). He serves as a consultant to Allergen, Inc.; Eli Lilly and Company; Lundbeck; Mitsubishi Tanabe Pharma Development America; Prismic Pharmaceuticals; SK Pharma; Roche; Shire Pharmaceuticals; Taisho Pharmaceutical Inc.; 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.; and Skyland Trail. He serves on the board of directors of the American Foundation for Suicide Prevention (AFSP); Anxiety Disorders Association of America (ADAA); GratitudeAmerica, Inc.; NovaDel Pharma, Inc. (2011); and Skyland Trail. He is a stockholder of AbbVie Inc,; Celgene Corporation; CeNeRx BioPharma; PharmaNeuroBoost; Reevax Pharmaceuticals LLC; Seattle Genetics, Inc.; and Xhale, Inc. His other financial income sources or equity of $10,000 or more include American Psychiatric Publishing; BioPharma; CeNeRx NovaDel Pharma, Inc.; Pharmaneuroboost; Revaax Pharmaceuticals LLC; and Xhale, Inc. 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. McIntyre has received grant/research support from the National Alliance for Research on Schizophrenia and Depression (NARSAD); National Institutes of Mental Health; Stanley Medical Research Institute; AstraZeneca; Eli Lilly and Company; Janssen-Ortho Inc.; Lundbeck; Pfizer Inc.; and Shire. He serves on the speakers bureau for Eli Lilly and Company; Janssen-Ortho Inc.; Lundbeck; Merck & Co., Inc.; and Pfizer Inc.. He is on the advisory boards of AstraZeneca; Bristol-Myers Squibb Company; Eli Lilly and Company; The France Foundation; GlaxoSmithKline; Janssen-Ortho Inc.; Lundbeck; Merck & Co., Inc.; Organon; Pfizer Inc.; and Shire.

Dr. Thase has disclosed that he has received grant support from the Agency for Healthcare Research and Quality; Eli Lilly and Company; Forest Pharmaceuticals, Inc.; National Institute of Mental Health; Otsuka America Pharmaceutical, Inc. He serves as a consultant for Alkermes, Inc.; AstraZeneca; Bristol-Myers Squibb Company; Cerecor Inc.; 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; Novartis; Otsuka America Pharmaceutical, Inc.; Ortho-McNeil-Janssen Pharmaceuticals, Inc. (Johnson & Johnson); Pamlab, LLC; Pfizer Inc. (formerly Wyeth Ayerst Pharmaceuticals); PGxHealth, Inc; PGx Health Inc.; Shire US Inc.; Sunovion Pharmaceuticals, Inc.; Takeda Pharmaceuticals North America, Inc. He has disclose equity holdings in MedAvante, Inc. He has received royalties from the American Psychiatric Foundation; Guilford Publications; Herald Publishing House; W.W. Norton & Company, Inc. He reports that his spouse is employed by Peloton Advantage, LLC, which does business with Pfizer 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.

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

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

Disclosures were obtained from the CME Outfitters, LLC staff: 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 Otsuka America Pharmaceutical, 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).

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