• S1 Episode 1: Novel Treatments in Major Depressive Disorder: Ketamine and Esketamine
    May 11 2022

    Madhukar Trivedi, MD, and Manish Jha, MD, MBBS, review the evidence on the efficacy of esketamine and ketamine as a treatment for major depressive disorder.

    Relevant disclosures can be found with the episode show notes on Medscape.com (https://www.medscape.com/viewarticle/968556). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

    Resources

    Symptom Clusters as Predictors of Late Response to Antidepressant Treatment https://www.psychiatrist.com/jcp/depression/symptom-clusters-predictors-late-response-antidepressant/

    Intranasal Esketamine https://www.janssenlabels.com/package-insert/product-monograph/prescribing-information/SPRAVATO-pi.pdf

    Sequenced Treatment Alternatives to Relieve Depression (STAR*D) Study https://www.nimh.nih.gov/funding/clinical-research/practical/stard

    Clinical Results for Patients With Major Depressive Disorder in the Texas Medication Algorithm Project https://jamanetwork.com/journals/jamapsychiatry/fullarticle/482026

    Efficacy and Safety of Olanzapine/Fluoxetine Combination vs Fluoxetine Monotherapy Following Successful Combination Therapy of Treatment-Resistant Major Depressive Disorder https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4207330/

    Esketamine Nasal Spray for Rapid Reduction of Depressive Symptoms in Patients With Major Depressive Disorder Who Have Active Suicide Ideation With Intent: Results of a Phase 3, Double-Blind, Randomized Study (ASPIRE II) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7816667/

    Esketamine Nasal Spray for the Rapid Reduction of Depressive Symptoms in Major Depressive Disorder With Acute Suicidal Ideation or Behavior https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8407443/

    Ketamine Versus Midazolam for Recurrence of Suicidality in Adolescents https://clinicaltrials.gov/ct2/show/NCT04592809

    Youth Depression and Suicide Research Network (YDSRN) https://clinicaltrials.gov/ct2/show/NCT04572321

    The Neurobiology of Depression, Ketamine and Rapid-Acting Antidepressants: Is it Glutamate Inhibition or Activation? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6165688/

    Effect of Ketamine on Limbic GABA and Glutamate: A Human In Vivo Multivoxel Magnetic Resonance Spectroscopy Study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7507577/

    Identifying Novel Mechanisms and Treatment Targets for Irritability and Aggression in Psychiatric Disorders https://www.nature.com/articles/s41386-021-01166-4

    Ketamine Versus Midazolam for Recurrence of Suicidality in Adolescents https://clinicaltrials.gov/ct2/show/NCT04592809

    Ketamine for Depression: An Update https://www.biologicalpsychiatryjournal.com/article/S0006-3223(16)32579-3/fulltext

    MDMA-Assisted Therapy for Severe PTSD: A Randomized, Double-Blind, Placebo-Controlled Phase 3 Study https://www.nature.com/articles/s41591-021-01336-3

    Trial of Psilocybin versus Escitalopram for Depression https://www.nejm.org/doi/full/10.1056/NEJMoa2032994

    The Clinical Pharmacology and Potential Therapeutic Applications of 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT) https://onlinelibrary.wiley.com/doi/10.1111/jnc.15587

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    23 mins
  • S1 Episode 2: The Role of Transcranial Magnetic Stimulation in Major Depressive Disorder
    May 11 2022

    Madhukar Trivedi, MD, and Jonathan Downar, MD, review the evidence on the efficacy of transcranial magnetic stimulation as a treatment for major depressive disorder.

    Relevant disclosures can be found with the episode show notes on Medscape.com (https://www.medscape.com/viewarticle/968557). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

    Resources

    Transcranial Magnetic Stimulation https://www.medscape.com/answers/286759-14790/what-is-the-role-of-transcranial-magnetic-stimulation-tms-in-the-treatment-of-major-depressive-disorder-clinical-depression

    Treatment-Resistant Depression https://www.medscape.com/viewarticle/431515_7

    ECT https://emedicine.medscape.com/article/1525957-overview

    Sequenced Treatment Alternatives to Relieve Depression (STAR*D) Study https://www.nimh.nih.gov/funding/clinical-research/practical/stard

    FDA Clears TMS Device for Resistant Depression https://www.medscape.com/viewarticle/777357

    FDA Clears Brain Stimulation Device for OCD https://www.medscape.com/viewarticle/900889

    FDA Clears First Brain Stimulation Device to Help Smokers Quit https://www.medscape.com/viewarticle/936234

    Neuroanatomy of Decision-making https://www.medscape.com/viewarticle/731957_5

    Customized Brain Stimulation: New Hope for Severe Depression https://www.medscape.com/viewarticle/960276

    Subcallosal Cingulate Deep Brain Stimulation for Treatment-Resistant Depression: A Multisite, Randomised, Sham-Controlled Trial https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(17)30371-1/fulltext

    High-Dose Spaced Theta-Burst TMS as a Rapid-Acting Antidepressant in Highly Refractory Depression https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5837258/pdf/awx379.pdf

    Stanford Accelerated Intelligent Neuromodulation Therapy for Treatment-Resistant Depression https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2019.19070720

    A pilot study of magnetic seizure therapy for treatment-resistant obsessive-compulsive disorder https://onlinelibrary.wiley.com/doi/10.1002/da.23097

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    22 mins
  • S1 Episode 3: The Role of the Gut Microbiome in Major Depressive Disorder: Where the Research Is Now and Where It Is Headed
    Jun 9 2022

    How does the gut microbiome affect the brain? Madhukar Trivedi, MD, and Jane Foster, PhD, discuss the current evidence and clinical takeaways.

    Relevant disclosures can be found with the episode show notes on Medscape.com (https://www.medscape.com/viewarticle/968558). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

    Resources

    Microbiome https://www.medscape.com/resource/microbiome

    Modulating Brain Function With Microbiota https://www.science.org/doi/10.1126/science.abo4220

    A Systematic Review of Gut Microbiota Composition in Observational Studies of Major Depressive Disorder, Bipolar Disorder and Schizophrenia https://www.nature.com/articles/s41380-022-01456-3

    Clinicaltrials.gov, search for phase 3 studies, recruiting, and keyword "probiotic" https://clinicaltrials.gov/ct2/results?term=probiotic&Search=Apply&recrs=a&age_v=&gndr=&type=&rslt=&phase=2

    Review Article: The Future of Microbiome-Based Therapeutics https://onlinelibrary.wiley.com/doi/10.1111/apt.17049

    A Randomized Controlled Trial of Dietary Improvement for Adults With Major Depression (The 'SMILES' Trial) https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0791-y

    Consumption of Fermented Milk Product With Probiotic Modulates Brain Activity https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3839572/

    Gut-Microbiota-Targeted Diets Modulate Human Immune Status https://www.cell.com/cell/fulltext/S0092-8674(21)00754-6

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    21 mins
  • S1 Episode 4: Applying Measurement-Based Care in Major Depressive Disorder
    Jul 13 2022

    Drs Madhukar Trivedi and Bradley Gaynes discuss the benefits of measurement-based care and how best to deliver it for patients with major depressive disorder.

    Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/968559). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

    Resources

    Patient Health Questionnaire-9 (PHQ-9) https://reference.medscape.com/calculator/271/patient-health-questionnaire-9-phq-9

    Clinical Results for Patients With Major Depressive Disorder in the Texas Medication Algorithm Project https://jamanetwork.com/journals/jamapsychiatry/fullarticle/482026

    Depression, IV: STAR*D Treatment Trial for Depression https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.160.2.237#F1

    APA Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts https://www.apa.org/depression-guideline/guideline.pdf

    The Efficacy of Measurement-Based Care for Depressive Disorders: Systematic Review and Meta-analysis of Randomized Controlled Trials https://www.psychiatrist.com/jcp/depression/measurement-based-care-depression/

    Final Recommendation Statement – Depression in Adults: Screening https://www.uspreventiveservicestaskforce.org/uspstf/document/RecommendationStatementFinal/depression-in-adults-screening

    Nonpharmacologic Versus Pharmacologic Treatment of Adult Patients With Major Depressive Disorder: A Clinical Practice Guideline From the American College of Physicians https://www.acpjournals.org/doi/10.7326/M15-2570

    The 16-Item Quick Inventory of Depressive Symptomatology (QIDS), Clinician Rating (QIDS-C), and Self-report (QIDS-SR): A Psychometric Evaluation in Patients With Chronic Major Depression https://www.biologicalpsychiatryjournal.com/article/S0006-3223(02)01866-8/fulltext

    Hamilton Depression Rating Scale (HAM-D or HDRS) https://reference.medscape.com/calculator/146/hamilton-depression-rating-scale-ham-d-or-hdrs

    Montgomery and Åsberg Depression Rating Scale (MADRS) https://www.apa.org/depression-guideline/montgomery-asberg-scale.pdf

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    23 mins
  • S1 Episode 5: The Role of Sleep in Major Depressive Disorder
    Aug 18 2022

    Drs Madhukar Trivedi and Andrew Krystal disentangle the complex relationship between sleep and major depressive disorder.

    Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/968560). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

    Resources

    Biomarkers of Depression and Treatment Response (SUNSET) https://clinicaltrials.gov/ct2/show/NCT04581902

    Customized Brain Stimulation: New Hope for Severe Depression https://www.medscape.com/viewarticle/960276

    Closed-Loop Deep Brain Stimulation for Major Depression (PReSiDio) https://clinicaltrials.gov/ct2/show/NCT04004169

    Insomnia in Patients With Depression: A STAR*D Report https://www.cambridge.org/core/journals/cns-spectrums/article/abs/insomnia-in-patients-with-depression-a-stard-report/2C9EB9396B44FD201E15927874FADC05

    Prevalence of Obstructive Sleep Apnea in Suicidal Patients With Major Depressive Disorder https://www.sciencedirect.com/science/article/abs/pii/S0022395619302018?via%3Dihub

    Sleep Disorders as Core Symptoms of Depression https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181883/

    Treating Insomnia in Depression: Insomnia Related Factors Predict Long-term Depression Trajectories https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5841584/

    Mirtazapine Tablet - Uses, Side Effects, and More https://www.webmd.com/drugs/2/drug-13706-4047/mirtazapine-oral/mirtazapine-oral/details

    Cognitive Behavioral Insomnia Therapy for Those With Insomnia and Depression: A Randomized Controlled Clinical Trial https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5806549/

    Efficacy of Cognitive-Behavioral Therapy for Insomnia Combined With Antidepressant Pharmacotherapy in Patients With Comorbid Depression and Insomnia: A Randomized Controlled Trial https://www.psychiatrist.com/jcp/depression/cbt-for-insomnia-in-patients-with-comorbid-depression-and-insomnia/

    Cognitive Behavioural Therapy for Insomnia (CBT-I) to Treat Depression: A Systematic Review https://www.sciencedirect.com/science/article/abs/pii/S0022399917308486

    Eszopiclone - Uses, Side Effects, and More https://www.webmd.com/drugs/2/drug-92330/eszopiclone-oral/details

    Eszopiclone Co-Administered With Fluoxetine in Patients With Insomnia Coexisting With Major Depressive Disorder https://www.biologicalpsychiatryjournal.com/article/S0006-3223(06)00185-5/fulltext

    brexanolone (Rx) https://reference.medscape.com/drug/zulresso-brexanolone-1000299

    Sleep Disturbances as an Evidence-Based Suicide Risk Factor https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6613558/

    Reducing Suicidal Ideation Through Insomnia Treatment (REST-IT): A Randomized Clinical Trial https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2019.19030267

    Insomnia Severity Index (ISI) https://reference.medscape.com/calculator/820/insomnia-severity-index-isi

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    27 mins
  • S1 Episode 6: Psychedelics and Major Depressive Disorder: A Lot of Promise and a Lot of Questions
    Sep 14 2022

    Drs Madhukar Trivedi and Gregory Fonzo discuss the state of evidence and models for the use of psychedelic drugs in patients with major depressive disorder.

    Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/968561). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

    Resources

    Depression https://emedicine.medscape.com/article/286759-overview

    What Is the Role of Transcranial Magnetic Stimulation (TMS) in the Treatment of Major Depressive Disorder (Clinical Depression)? https://www.medscape.com/answers/286759-14790/what-is-the-role-of-transcranial-magnetic-stimulation-tms-in-the-treatment-of-major-depressive-disorder-clinical-depression

    New Expert Guidance on Ketamine for Resistant Depression https://www.medscape.com/viewarticle/948097

    Trending Clinical Topic: Psychedelics https://reference.medscape.com/viewarticle/971428

    The Safety and Efficacy of COMP360 Psilocybin Therapy in Treatment-Resistant Depression: Results from a Phase IIb Randomized Controlled Trial https://j8g9v7z6.rocketcdn.me/wp-content/uploads/2022/05/Compass_APA_Poster_v5.1.pdf

    Psilocybin Effective Up to 12 Weeks in Severe Depression https://www.medscape.com/viewarticle/974935

    Psychedelic Resting-State Neuroimaging: A Review and Perspective on Balancing Replication and Novel Analyses https://www.sciencedirect.com/science/article/pii/S0149763422001786

    LSD Alters Dynamic Integration and Segregation in the Human Brain https://www.sciencedirect.com/science/article/pii/S1053811920311381

    Center for Psychedelic Research & Therapy https://dellmed.utexas.edu/units/center-for-psychedelic-research-and-therapy

    MDMA-Assisted Therapy for Severe PTSD: A Randomized, Double-Blind, Placebo-Controlled Phase 3 Study https://www.nature.com/articles/s41591-021-01336-3

    The Emerging Science of Microdosing: A Systematic Review of Research on Low Dose Psychedelics (1955-2021) and Recommendations for the Field https://www.sciencedirect.com/science/article/pii/S0149763422001956

    Oregon Psilocybin Services https://www.oregon.gov/oha/PH/PREVENTIONWELLNESS/Pages/Oregon-Psilocybin-Services.aspx

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    22 mins
  • S2 Episode 1: 'Primary Care First' Model to Screen and Treat Major Depressive Disorder
    Mar 7 2023

    Drs Madhukar Trivedi and Manish Jha discuss the use of a "primary care first" model to screen and treat depression, emphasizing measurement-based care that can triage to specialty care when needed.

    Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/984454). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

    Resources

    Depression https://emedicine.medscape.com/article/286759-overview

    USPSTF Screening for Depression in Adults https://www.uspreventiveservicestaskforce.org/uspstf/document/RecommendationStatementFinal/depression-in-adults-screening

    Depression Screening Patterns, Predictors, and Trends Among Adults Without a Depression Diagnosis in Ambulatory Settings in the United States https://pubmed.ncbi.nlm.nih.gov/29983110/

    Primary versus Specialty Care Outcomes for Depressed Outpatients Managed With Measurement-Based Care: Results From STAR*D https://pubmed.ncbi.nlm.nih.gov/18247097/

    The PHQ-9: Validity of a Brief Depression Severity Measure https://pubmed.ncbi.nlm.nih.gov/11556941/

    VitalSign6: A Primary Care First (PCP-First) Model for Universal Screening and Measurement-Based Care for Depression https://pubmed.ncbi.nlm.nih.gov/31091770/

    A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7 https://pubmed.ncbi.nlm.nih.gov/16717171/

    Prevalence and Impact of Diagnosed and Undiagnosed Depression in the United States https://pubmed.ncbi.nlm.nih.gov/36134073/

    FDA Approves First Treatment for Post-partum Depression
    https://www.fda.gov/news-events/press-announcements/fda-approves-first-treatment-post-partum-depression

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    23 mins
  • S2 Episode 2: Race, Equity in Care, and Cultural Competence in Major Depressive Disorder
    Mar 7 2023

    Drs Madhukar Trivedi and Lorenzo Norris address the issues of race, equity in care, and the importance of cultural competence when treating patients with major depressive disorder.

    Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/984455). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

    Resources

    Depression https://emedicine.medscape.com/article/286759-overview

    Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) https://www.psychiatry.org/psychiatrists/practice/dsm

    The Cultural Formulation Interview: Building the Case for Cultural Competence in Clinical Care https://pubmed.ncbi.nlm.nih.gov/36722093/

    Shared Decision Making https://www.medscape.org/shareddecisionmaking

    Promoting Collaborative Psychiatric Care Decision-Making in Community Mental Health Centers: Insights From a Patient-Centered Comparative Effectiveness Trial https://pubmed.ncbi.nlm.nih.gov/33119363/

    Structured Clinical Interview for the DSM https://www.appi.org/products/structured-clinical-interview-for-dsm-5-scid-5

    Psychometric Properties of Structured Clinical Interview for DSM-5 Disorders-Clinician Version (SCID-5-CV) https://pubmed.ncbi.nlm.nih.gov/33729681/

    The Patient Health Questionnaire-2: Validity of a Two-Item Depression Screener https://pubmed.ncbi.nlm.nih.gov/14583691/

    The PHQ-9: Validity of a Brief Depression Severity Measure https://pubmed.ncbi.nlm.nih.gov/11556941/

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    20 mins