Description
Although rarely appreciated, innovative psychopharmacology has been the essence of historical developments in psychopharmacology. The serendipitous discovery of conventional antipsychotic medications and tricyclic antidepressants in the mid-50s was the force behind the later development of more effective and tolerable treatments. Though not at the forefront of clinical psychiatry, innovative psychopharmacology is more frequently employed in daily practice than reported, which is partly due to the medicolegal and ethical implications of using non-approved treatments. However, most of the potential risks can be mitigated if the innovative treatment is documented as scientifically sound and hypothesis-driven, along with informed consent explaining the innovative treatment's risks, benefits, and alternatives. This process is no different from the documentation required for patients' eligibility to receive risky but effective treatments, such as clozapine or intranasal esketamine, to manage treatment-refractory symptoms. However, it might be challenging to formulate a hypothesis in extreme cases of treatment resistance. In such cases, innovative psychopharmacology may still be justified based on clinical reasoning, provided that ethical safeguards are in place. The ethical concerns can also be addressed by not imposing novel treatment ideas on our patients without explicitly discussing the rationale behind the move, which is no different from psychoeducation for non-innovative treatments. Since clinical innovations have improved patient outcomes and are at the center of significant advances in psychopharmacology, innovative treatment strategies are justifiable and should be ethically required. Unfortunately, due to their unique patient-specific nature, innovative psychopharmacological strategies do not lend themselves easily to clinical trials. The National Institute of Mental Health does not fund efficacy trials in psychopharmacology, which leaves the industry to develop novel treatments primarily in short-term efficacy trials by including close to an ideal patient population to seek drug approval. Although these preclinical trials often lack long-term data, clinicians are usually required to manage psychiatric patients on a long-term basis with agents that are not FDA-approved for maintenance therapy, which is no different from innovative psychopharmacology. We believe that innovative psychopharmacology should be taught and promoted within ethical and medicolegal guidelines. This session will benefit clinicians of all stripes but primarily targets psychiatry residents to generate early interest and motivation in learning advanced psychopharmacology. Presenters will examine innovative but hypothesis-driven and/or ethically conducted psychopharmacological interventions in treatment-refractory patients, using evidence-based (when available) and published case reports/series (1-6) from our group in adult, geriatric, and addiction practices.
Format
Recorded webinar.
This content was recorded during the APA 2023 Annual Meeting.
Learning Objectives
- Learn historical, medicolegal, and ethical aspects of innovative and collaborative learning in psychopharmacology.
- Differentiate between evidence-based and innovative psychopharmacology in the management of treatment-refractory psychiatric patients.
- Learn hypothesis-driven neurobiological justification for innovative use of psychotropic medications.
- Understand the clinical application of evidence-based and mechanism-based psychopharmacology primarily exemplified by published cases in adult, geriatric, and addiction psychiatry.
- Involve in an interactive case-based discussion and respond to the relevant questions using electronic media.
Target Audience
Residents/Fellows, Psychiatrists, Psychologists
Estimate Time to Complete
Estimated Duration: 1.5 hours
Program Start Date: May 1, 2025
Program End Date: May 1, 2028
How to Earn Credit
Participants who wish to earn AMA PRA Category 1 Credit™ may do so after completing all sections of the course including the evaluation. After evaluating the program, course participants will be provided with an opportunity to claim hours of participation and print an official CME certificate (physicians) or certificate of participation (non-physicians) showing the completion date and hours earned.
Continuing Education Credit
In support of improving patient care, the American Psychiatric Association is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
The APA designates this live activity 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.
Faculty and Planner Disclosures
The American Psychiatric Association adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Medical Education. Any individuals in a position to control the content of a CME activity — including faculty, planners, reviewers or others — are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.
Instructors
- Mujeeb Shad, MD
- Obiora Onwuameze, MD, MS, PhD
- Vimal Aga, MD
- Jair Soares, MD, PhD
Planners
- Vishal Madaan, MD, Chief of Education and Deputy Medical Director at the American Psychiatric Association.
Accessibility for Participants with Disabilities
The American Psychiatric Association is committed to ensuring accessibility of its website to people with disabilities. Please contact the American Psychiatric Association at 202-559-3900, if you require assistance seven (7) business days prior to the start of a live webinar.
Technical Requirements
This internet-based CME activity is best experienced using any of the following:
- The latest and 2nd latest public versions of Google Chrome, Mozilla Firefox, or Safari
- Internet Explorer 11+
This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Acrobat Reader, Microsoft PowerPoint, and Windows Media Player.
Optimal System Configuration:
- Browser: Google Chrome (latest and 2nd latest version), Safari (latest and 2nd latest version), Internet Explorer 11.0+, Firefox (latest and 2nd latest version), or Microsoft Edge (latest and 2nd latest version)
- Operating System: Windows versions 8.1+, Mac OS X 10.5 (Leopard) +, Android (latest and 2nd latest version), or iOS/iPad OS (latest and 2nd latest version)
- Internet Connection: 1 Mbps or higher
Minimum Requirements:
- Windows PC: Windows 8.1 or higher; 1 GB (for 32-bit)/2 GB (for 64-bit) or higher RAM; Microsoft DirectX 9 graphics device with WDDM driver; audio playback with speakers for programs with video content
- Macintosh: Mac OS X 10.5 or higher with latest updates installed; Intel, PowerPC G5, or PowerPC G4 (867MHz or faster) processor; 512 MB or higher RAM; audio playback with speakers for programs with video content
For assistance: Contact educme@psych.org for questions about this activity | Contact learningcenter@psych.org for technical assistance