Challenges in Depression Care: Suicidality
and Drug Emergent Effects

Introduction

Jeffrey Susman, MD, Professor and Chair, Department of Family Medicine, University of Cincinnati College of Medicine poses a number of primary care-oriented questions to John Zajecka, MD, Associate Professor, Department of Psychiatry, Rush University Medical Center on the topic of evaluating suicidality in the depressed patient and on issues of improving adherence to treatment in the context of achieving remission, and early and late emergent drug side effects. Their discussions also address the importance of the team approach to depression management and the long-term outlook for managing depression as chronic disorder.

Intended Audience

This continuing medical education program is intended for primary care physicians and other healthcare professionals who manage patients with depressive disorders.

Educational Objectives

After completing this activity, participants should be better able to:

• Evaluate suicide risk in patients with depression.
• Recognize the importance of adherence to drug therapy and the impact of drug-related side effects on adherence to pharmacotherapy.
• Recognize the importance of developing a relationship with a mental health professional for patient referral in cases of treatment resistant depression.
• Describe the long-term outlook of management of the patient with depression.

Information on CME credit

The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The American Medical Association designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Instructions for CME credit

This online enduring material is presented as a video webcast with attendant slide presentation. To receive credit, please view all of the presentations of this CME activity and evaluate the content presented. Complete both the pre- and post-test and activity evaluation.

The estimated time to complete this activity, including pre-test, review of the materials, and self-assessment and evaluation is 1.0 hour.

Principal Faculty

Wayne Katon, MD, Planning Committee Chair, Content Reviewer
Professor and Vice Chair
Department of Psychiatry and Behavioral Sciences
Director, Division of Health Services and Psychiatric Epidemiology
University of Washington School of Medicine
Seattle, WA

Michael S. Klinkman, MD, Planning Committee, Content Reviewer
Associate Professor, Department of Medicine
Associate Professor, Department of Psychiatry
Department of Family Medicine
Director, Primary Care Programs
University of Michigan Depression Center
Ann Arbor, MI

Kurt Kroenke, MD, Planning Committee, Content Reviewer
Professor of Medicine
Indiana University School of Medicine
Research Scientist, Regenstrief Institute, Inc.
Indianapolis, IN

Jeffrey Susman, MD, Author/Presenter
Professor and Chair
Department of Family Medicine
University of Cincinnati College of Medicine
Cincinnati, OH

John Williams, MD, Planning Committee, Content Reviewer
Associate Professor of Medicine and Psychiatry
General Medicine
Duke University School of Medicine
Durham, NC

John Zajecka, MD, Author/Presenter
Associate Professor, Department of Psychiatry
Clinical Director, Treatment Research Center
Rush University Medical Center
Chicago, IL

R. Mark Evans, PhD, Planning Committee
Director, Healthcare Education Products and Standards
American Medical Association
Chicago, IL

Kristi Eidsvoog, PhD, Planning Committee
Content Manager
MedEd Architects, LLC
Chicago, IL

Patti Fitzgerald, Planning Committee
Manager, Product Development, Healthcare Education Products and Standards
American Medical Association
Chicago, IL

Faculty

Disclosure Policy

In order to assure the highest quality of CME programming, and to comply with the ACCME Standards for Commercial Support, the AMA requires that all faculty and planning committee members disclose relevant financial relationships with any commercial or proprietary entity producing health care goods or services relevant to the content being presented. We therefore obtain a completed disclosure and attestation form to inform the participant of any pertinent relationships disclosed, provided here.

These materials have been peer-reviewed by the members of the CME Advisory Board and the AMA Editorial Board to ensure the continued scientific accuracy and medical relevance of information presented and its independence from commercial bias. The AMA has control over all final content.

Dr. Katon: Advisory Board, Lilly, Wyeth; Speakers Bureau, Pfizer, Forest, GlaxoSmithKline

Dr. Klinkman: Advisory Board, Wyeth; Research Grant, Lilly; Independent Contractor, GE/Healthology

Dr. Kroenke: Research Grant, Lilly, Pfizer, Wyeth; Consultant, Lilly, Pfizer, Wyeth

Dr. Susman: Advisory Board, Pfizer, Forest, Wyeth; Consultant, Pfizer, Forest, Wyeth; Speaker's Bureau, Pfizer, Forest Wyeth

Dr. Williams: Nothing relevant to disclose

Dr. Zajecka: Advisory Board/Consultant: Abbott, Biovail, Bristol-Myers Squibb, Eli Lilly, Novartis, Otsuka, PamLab, Takeda, Wyeth-Ayerst; Grant/Research Support: Alza, AstraZeneca, Bristol-Myers Squibb, Cephalon, CNS Response, Cyberonics, Eli Lilly, Forest Laboratories, McNeil, Novartis, PamLab, sanofi-aventis; Speaker’s Bureau: Abbott, AstraZeneca, Bristol-Myers Squibb, Cyberonics, Eli Lilly, Mallinckrodt, PamLab, Pfizer, GlaxoSmithKline, Wyeth-Ayerst

Dr. Evans: Nothing relevant to disclose

Dr. Eidsvoog: Nothing relevant to disclose

Ms. Fitzgerald: Nothing relevant to disclose

Acknowledgement of Support

This CME publication was supported through an independent education grant from Eli Lilly & Company and produced in accordance with the AMA Standards for Industry-Supported Multimedia Continuing Medical Education and Other Communications.

Term of approval

Original Release Date- June 2008

Date of the Most Recent Review- July 2009

Expiration Date- December 2010