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Depression as an Altered Brain State and Medications to Treat It 

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Michael Thase, M.D. is Professor of Psychiatry at the University of Pennsylvania School of Medicine.

Dr. Thase has published hundreds of articles in peer-reviewed journals and is among the leading figures in the world on mood disorders. His presentation style is personable, down-to-earth, and evinces his genuine concern and decades of experience working with patients who have suffered from a vast range of mood disturbances.

In the current video Dr. Thase provides information that is essential for accurate case conceptualization when working with depressed individuals. This includes recent findings demonstrating that depression is a disorder that alters its own course over time, becoming de-coupled from the negative life events that often precipitate early episodes. Thus, depression that is not successfully treated becomes increasingly chronic, debilitating, and treatment-resistant. In a straightforward, easily digestible manner, Dr. Thase describes the changes that occur at multiple levels – cellular, structural, and functional – that likely underpin the naturally deteriorating course of depression.

Dr. Thase also provides the facts about the relative efficacy of various classes of antidepressants. He addresses the popular but false belief that although a particular individual may respond to one medication better than another, overall, the numerous currently available antidepressants are equally effective. With concrete data and interesting diagrams, Dr. Thase reveals which antidepressant drugs are most effective for various subgroups of depressed patients. He candidly discusses side effect profiles, dosage requirements, etc. for the various classes of antidepressants. Augmentation strategies (i.e., adding a second or third medication) are also addressed.

During this presentation viewers will learn the four reasons that SSRIs quickly became the preferred class of antidepressants and how we know that drugs in this class do not produce their antidepressant effects simply by increasing availability of serotonin at the synapse. The likely mechanisms by which SSRIs have their effects will be discussed. Viewers will also learn many other diverse, fascinating facts – e.g., the degree to which our estimates of the efficacy of psychiatric meds has dropped during recent years as legislation has forced pharmaceutical companies to provide access to all the studies they conduct, not just the ones that turn out in their favor.

Learning Objectives: After viewing this program, you will be able to...

1) describe the natural course of depression that is not successfully treated.

2) describe at least one difference at the cellular level (neurons) and one difference in brain structure that have been observed in studies comparing nondepressed individuals to those who have a longstanding history of depression.

3) explain the role of ‘brain-derived neurotrophic factor’ in the maintenance and health of neurons.

4) state which classes of antidepressant drugs (SSRI, SNRI, tricyclics, and MAOIs) are more effective for particular subgroups of depressed patients (e.g., inpatients vs outpatients vs atypical depression).

This program is appropriate for a broad range of mental health professionals (psychologists, social workers, and counselors) – any clinican who works with patients who suffer from depression.

CE credit: 3 hours

Dr. Thase currently has research funding from the National Institute of Mental Health, Eli Lilly and Company, Sepracor, and GlaxoSmithKline.

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