Section - Quick Takes

01. Efficacy and Safety of Esketamine Nasal Spray Plus an Oral Antidepressant in Elderly Patients With Treatment-Resistant Depression—TRANSFORM-3

Published on August 1, 2020 Expired on April 1, 2023

James Phelps, M.D.

Research Editor - Psychopharmacology Institute

Key Points

Nasal esketamine did not outperform placebo in a randomized trial in patients 65 or older when initiated along with a new antidepressant.

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Here is a question in a new randomized trial: How many investigators employed by the manufacturer does it take before you would not even bother to look at the results? The answer is, it depends. Suppose the new drug addresses a problem for which we have little to offer at present. Suppose many people at risk might benefit.

Let’s look at a new study of esketamine for treatment-resistant depression in the elderly. Most of the investigators were employed by Janssen, maker of esketamine nasal spray. Thus, investigators were consultants or speakers. That is almost enough for me to stop right there. However, the topic was tantalizing. Is a simple tool available for patients whose remaining years of life could be miserable? We can jump to the results and work backward from there if warranted. Nevertheless, the results pointed out, “Esketamine did not achieve statistical significance for the primary endpoint.” Perhaps

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02. Cannabinoids for the Treatment of Mental Disorders and Symptoms of Mental Disorders: A Systematic Review and Meta-Analysis

Learning Objectives:

After completing this activity, the learner will be able to:

Evaluate a new randomized trial of nasal esketamine – in this case, a negative trial per the primary endpoint. But there is more to learn here, about this medication – and industry support of research.
Evaluate the evidence for cannabinoids as potential treatments for depression, anxiety, PTSD, and other mental illnesses.
Evaluate several meta-analyses of omega-3 fatty acid efficacy in the treatment of depression and draw a working conclusion as to whether to recommend them (and if so, which formulations and dosages).
Evaluate the conflicting evidence base for long-acting injectable antipsychotics, relative to oral antipsychotics, for the prevention of relapse and rehospitalization in patients with schizophrenia.
Review the most recent investigations of the effect of hormonal contraception on mood, including associated neurophysiologic changes.

Original Release Date: August 1, 2020

Review and Re-release Date: March 1, 2023

Expiration Date: April 1, 2023

Relevant Financial Disclosures:

James Phelp declares the following interests:

- McGraw-Hill: book on bipolar disorder

- W.W. Norton & Co.: book on bipolar disorder

All of the relevant financial relationships listed above have been mitigated by Medical Academy and the Psychopharmacology Institute.

Contact Information: For questions regarding the content or access to this activity, contact us at support@psychopharmacologyinstitute.com

Instructions for Participation and Credit:

Participants must complete the activity online during the valid credit period that is noted above.

Follow these steps to earn CME credit:

View the required educational content provided on this course page.
Answer the quiz for promoting retention of knowledge.
Complete the Post Activity Evaluation for providing the necessary feedback for continuing accreditation purposes and for the development of future activities. NOTE: Completing the Post Activity Evaluation after the quiz is required to receive the earned credit.
Download your certificate.

Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation Statement

Medical Academy designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.