September 23, 2021 - The 11th Peter Miller Musser, Lecture in Depression
The 11th Peter Miller Musser, Lecture in depression grand rounds: Towards Rational Treatment Discovery in Depression: Ketamine and Photobiomodulation
Major depressive disorder (MDD) is a severe illness affecting 21 million Americans (~10%) per year (Kessler et al, 2012) and is the second leading cause of global disability (GBD Disease and Injury Incidence and Prevalence, 2015). Although effective treatments exist, a large proportion (~30%) of MDD patients do not improve, even after several antidepressant treatments (Voineskos et al, 2020). Until very recently, treatment discovery in MDD has been largely serendipitous. There is a clear need for novel treatments focused on specific biological abnormalities present in MDD.
We will review two novel treatments for MDD (ketamine and photobiomodulation) that were developed based on insights regarding associated biological abnormalities. First, data on glutamate system abnormalities in MDD justified the development of ketamine and its enantiomer esketamine (both NMDA glutamate receptors antagonists) as rapid-acting antidepressant treatments. Also, significant evidence of abnormal brain mitochondrial energy metabolism in MDD led to the development of transcranial photobiomodulation (t-PBM), which stimulates the mitochondrial respiratory chain; early data suggest that t-PBM may be an effective treatment in MDD.
This program is intended for: Psychiatrists, Psychologists, Fellows, Residents, Interns and Nurses
At the end of this presentation participants will be able to:
- Discuss the limited efficacy of existing antidepressants for major depressive disorder (MDD) and the need for treatments based on biological mechanisms
- List the advantages of ketamine and esketamine as rapid acting antidepressants targeting the glutamate system
- Identify mitochondrial energy metabolism abnormalities in MDD and the rationale for developing transcranial photobiomodulation as a treatment
Dan Iosifescu, MD, MMSc
- 1.00 AMA PRA Category 1 Credit™
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of McLean Hospital and Massachusetts General Hospital. McLean Hospital is accredited by the ACCME to provide continuing medical education for physicians.
McLean Hospital designates this Enduring activity for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
- 1.00 Nursing Contact Hours
Massachusetts General Laws, Chapter 13, sections 13, 14, 14A, 15 and 15D and Chapter 112, sections 74 through 81C authorize the Board of Registration in Nursing to regulate nursing practice and education.
This program meets the requirements of the Massachusetts Board of Registration in Nursing (244 CMR 5.00) for 1.00 contact hours of nursing continuing education credit. Advance practice nurses, please note: Educational activities which meet the requirements of the ACCME (such as this activity) count towards 50% of the nursing requirement for ANCC accreditation.
- 1.00 Participation
This course allows other providers to claim a Participation Certificate upon successful completion of this course.
Participation Certificates will specify the title, location, type of activity, date of activity, and number of AMA PRA Category 1 Credit™ associated with the activity. Providers should check with their regulatory agencies to determine ways in which AMA PRA Category 1 Credit™ may or may not fulfill continuing education requirements. Providers should also consider saving copies of brochures, agenda, and other supporting documents.
- 1.00 Psychologists CE Credit
The Massachusetts General Hospital Department of Psychiatry is approved by the American Psychological Association to sponsor continuing education for psychologists. The Massachusetts General Hospital Department of Psychiatry maintains responsibility for this program and its content.
This offering meets the criteria for 1.00 Continuing Education (CE) credits per presentation for psychologists.
Dr. Iosifescu has the following financial disclosures:
- Advisory Board (Honoraria): Axsome, Sage
- Consulting (Honoraria): Allergan, Biogen, Jazz
- Principle Investor (Research Support): LiteCure, Otsuka