Offered by the Department of Psychiatry at Beth Israel Deaconess Medical Center, a teaching hospital of Harvard Medical School.

Psychopharmacology: A Master Class

Charles Nemeroff, MD, PhD

August 23 – 27, 2021 • Monday – Friday
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This seminar will begin with an updated review of modern neurobiology ranging from genomics, epigenetics and neurotransmitters systems to brain circuitry and imaging. The seminal role of child abuse and neglect in increased vulnerability to mood and anxiety disorders will be explored with a focus on the long-term persistent effects of early life trauma on the brain and the body. An update on the pathophysiology of the major mood and anxiety disorders will be described including new data on inflammation. The latest data on suicide will be presented including risk factors and strategies for prevention.

Treatment of schizophrenia, bipolar disorder, depression, anxiety, and women’s psychiatric disorders will be described. The evidence-based effectiveness of antipsychotic medications will be emphasized in psychotic disorders and as augmenting agents in major depression. Newer agents such as brexanolone and augmenting medications including pramipexole for the treatment of mood disorders will be discussed with an emphasis on treatment-resistant depression. The benefits and risks of ketamine and esketamine will be explored as well as the uses of ECT and TMS. Bipolar disorder and its treatment will be examined with particular emphasis on bipolar depression. The use of lithium as the gold standard of treatment will be emphasized. A comprehensive review of primary depression as well as depression comorbid with medical illnesses will be highlighted, particularly the role of depression in cardiovascular illness and the necessity for treatment.

The neurobiological mechanisms of anxiety and anxiety-spectrum disorders (including GAD, OCD, and panic disorders) as well as their treatment will be reviewed with a focus on management of treatment resistant post-traumatic stress disorder (PTSD). Medications for depression in women through the course of their lifecycle will be presented. Advances in personalized or precision medicine will be a major focus of the course including both pharmacotherapy and psychotherapy. The controversy concerning the use of pharmacogenomic tests to predict antidepressant treatment response will be discussed in detail.

The seminar will emphasize the establishment and importance of the therapeutic alliance when prescribing all psychotropic medications.

Upon completion of this activity, participants will be able to:

  • Apply the latest advances in the neurobiology of psychiatric disorders and understand the potential role of pharmacogenomic testing in the selection of specific psychiatric medications;
  • Assess and compare current mechanisms and latest treatment of psychotic disorders, schizophrenia and bipolar illness;
  • Evaluate treatment options for treatment resistant bipolar and unipolar depression including psychotherapies;
  • To assess the neurobiological mechanism and evidence-based treatment of depressive and anxiety spectrum disorders including PTSD;
  • Determine when to implement switch versus augmentation strategies for treatment resistant depression;
  • Analyze the use of ketamine with benefits and hazards in treatment resistant depression;
  • Demonstrate when to use ECT and TMS for the treatment of depression;
  • Review the data on risk factors for suicide and suicide presentation strategies;
  • Summarize latest findings about inflammation and stress as they apply to the treatment of depression and anxiety-spectrum disorders;
  • Recognize the role of psychiatric medications during a woman’s life cycle: pregnancy, delivery, post-partum, nursing and menopause;
  • Analyze the role of psychopharmacology and psychotherapy in the treatment of PTSD.

FACULTY

Charles Nemeroff, MD, PhD Matthew P. Nemeroff Professor and Chair Department of Psychiatry and Behavioral Sciences; Mulva Clinic for the Neurosciences; Director, Institute of Early Life Adversity Research, Dell Medical School, The University of Texas at Austin; past Leonard M. Miller Professor and Chairman, Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine; past President of the American College of Psychiatrists, International Society of Psychoneuroendocrinology and the American College of Neuropsychopharmacology; member of the National Academy of Medicine; author of over 1100 scientific articles and book chapters, Co-editor, Textbook of Psychopharmacology; Co-editor, Post Traumatic Stress Disorder.

Date and timeAgenda Item
Monday, August 23
9:30am – 10:00amConnect to Zoom
10:00am – 11:15amBasic Neuroscience: From Molecules to Symptoms: An updated and
clinically relevant review of neurobiology as it applies to the etiology and
pathophysiology of psychiatric illness, and psychotropic drug treatment
effects.
11:15am – 11:30amCoffee Break
11:30am – 1:15pmParadise Lost: The Neurobiology of Child Abuse and Neglect. A discussion
of the long term effects of child abuse and neglect on the brain and the body
and their implications for disease vulnerability and treatment response.
Tuesday, August 24
10:00am – 11:15amPrediction of Disease Vulnerability and Treatment Response in Mood
Disorders and PTSD: Personalized Medicine in Psychiatry: Personalized
medicine in psychiatry.
11:15am – 11:30amCoffee Break
11:30am – 1:15pmThe Status of Laboratory Testing to Predict Antidepressant
Response: Problems and Promises Promises. A discussion of the status of
pharmacogenomic and other biomarkers for predicting antidepressant
treatment response.
Wednesday, August 25
10:00am – 11:15amThe Management of Treatment Resistant Depression: The Art and the
Science: Management of treatment resistant depression with a focus on
psychopharmacological treatments; review of STAR*D study and other
evidence based clinical trials; Ketamine, ECT and TMS.
11:15am – 11:30amCoffee Break
11:30am – 1:15pmKetamine and Esketamine: The Amazing, The Good, The Bad, and The Ugly
A discussion of the data on the safety and efficacy of ketamine and
e–sketamine in the management of treatment resistant depression.
Thursday, August 26
10:00am – 11:15amProgress in Suicide Prevention: The epidemiology of suicide; suicide
prevention strategies.
11:15am – 11:30am Coffee Break
11:30am – 1:15pmManagement of Bipolar Disorder: Problems and Promises - Biology and
treatment of bipolar disorder; current standards of practice; special emphasis
on evidence-based treatments of bipolar depression.
Friday, August 27
10:00am – 11:15amNeurobiology and Treatment of Post-traumatic Stress Disorder - Biology,
epidemiology, and treatment of PTSD.
11:15am – 11:30amCoffee Break
11:30am – 1:15pmThe Interface of Medical and Psychiatric Disorders: Focus on Cancer and
Heart Disease The high rates of comorbidity of depression and certain
medical disorders and their treatment.
1:15pmAdjourn