College of Psychiatric and Neurologic Pharmacists

Title: Treatment Outcomes in Schizophrenia: Current Issues and Emerging Options

Location: The Broadmoor Hotel, Colorado Hall D/E/F.

Program Description:
Schizophrenia affects an estimated 1% of the world’s population, including 3.2 million Americans. Long-term maintenance with antipsychotic medication is recommended, but long-term treatment outcomes continue to be disappointing. Poor antipsychotic tolerability leads to poor treatment compliance and risk of relapse. In this continuing education symposium, faculty will discuss current issues and new options for improving treatment compliance and outcomes in schizophrenia. The discussion will focus on the relationship between relapse rates and adherence; strategies for determining when and how to consider switching therapies; the need to individualize patient treatment regimens; the effects of long-term treatment; and treatment challenges posed by special populations.

Educational Objectives:
After taking part in this activity, participants will be able to:

• Identify obstacles to treatment compliance; strategies for assessing clinical response; and pharmacologic management approaches with antipsychotic agents and adjunctive medications
• Compare the safety and tolerability profiles of first- and second-generation antipsychotic agents
• Review the pharmacologic profiles and recent clinical data for novel future treatment options for schizophrenia
• Outline the relationship between relapse rates and poor adherence
• Assess how and when to consider switching antipsychotic treatments

Faculty

Charles F. Caley, PharmD, BCPP, Chair
Associate Clinical Professor
University of Connecticut School of Pharmacy
Storrs, Connecticut

Daniel E. Casey MD
Professor of Psychiatry and Neurology
Oregon Health and Science University
Portland, Oregon

Deanna L. Kelly, PharmD, BCPP
Associate Professor of Psychiatry
Maryland Psychiatric Research Center
University of Maryland School of Medicine
Baltimore, Maryland

Registration

Web	www.ncme.com/cpnp
E-Mail	cpnp@ncme.com
Fax	1-201-867-2491
Phone	1-800-223-0433, ext. 291

This activity is a program of the Network for Continuing Medical Education .

Commercial Supporter:
This activity is supported by an educational grant from Solvay Pharmaceuticals Inc. and Wyeth Pharmaceuticals.

Accreditation and Designation of Credit

This program is approved for 1.5 hours of credit (0.15 CEU) and is sponsored by the University of Tennessee College of Pharmacy (UTCOP), who is approved by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. A statement of CE credit will be mailed within 4 weeks of successful completion of the posttest and evaluation of the program. ACPE Program # 064-999-07-230-L01.

Grievance Policy: A participant, sponsor, faculty member, or other individual wanting to file a grievance with respect to any aspect of a program sponsored or cosponsored by the UTCOP may contact the Associate Dean for Continuing Education in writing. The grievance will be reviewed and a response will be returned within 45 days of receiving the written statement. If not satisfied, an appeal to the Dean of the College of Pharmacy can be made for a second level of review.

Title: An Evidence-based Approach to the Management of Patients With Psychotic Disorders: The Role of the Pharmacist

Program Description:
Enhancing long-term patient functionality and returning the patient to the community is the ultimate goal of treatment for patients with psychotic disorders. Pharmacotherapeutic choices can be made that not only maximize symptom control, but also minimize adverse effects that may impinge upon long-term patient health. When choosing an antipsychotic for the management of a particular disorder, it is important to consider the differential pharmacologic profiles of these agents in order to personalize pharmacotherapy based on patient preference, prior response to treatment, and metabolic and cardiovascular health vulnerabilities. Newer medications are available that decrease positive and negative symptoms while improving cognition and decreasing sedation, which can ultimately increase adherence to medication and enhance long-term functionality. Switching to a different antipsychotic medication can often minimize adverse effects and maintain symptom control while maximizing patient quality of life and function. Changing pharmacologic treatment strategies can be difficult for health care providers. Initiating a slow cross-taper of the new medication and the adjunctive use of benzodiazepines and/or anticholinergics can often control treatment-emergent adverse events caused by the withdrawal of the old antipsychotic. This symposium will discuss the need for enhancing patient functionality and improving long-term recovery when treating patients with psychotic disorders. Evidence-based treatment strategies for the use of pharmacologic agents will be examined to help clinicians provide patients with optimal levels of care.

Educational Objectives:
At the conclusion of this educational activity, participants should be better able to:

• Review pharmacologic profiles of atypical antipsychotics and their clinical implications for patient functionality
• Outline management strategies for patients with acute psychotic disorders
• Identify long-term implications of treatment selection on overall patient health and quality of life
• Outline a sample strategy for switching between two antipsychotic agents, including length and type of taper, dose titration, and use of adjunctive agents
• Examine the use of adjunctive medications when initiating or switching pharmacologic agents for the treatment of patients with psychotic disorders

Faculty

Differential Pharmacology of Atypical Antipsychotics: Impact on Patient Functionality
C. Lindsay DeVane, PharmD
Professor and Vice Chair for Research
Clinical Neuroscience Division
Medical University of South Carolina
Charleston, South Carolina

Implementing Treatment Strategies to Stabilize Patients With Psychotic Disorders
Daniel E. Casey, MD
Chief of Psychiatric Research/Psychopharmacology at the VA Medical Center
Associate Director of Research at the Mental Illness Research, Education & Clinical Center
Oregon University Health Science Center
Portland, Oregon

Rational Choices for Improving and Enhancing Long-term Patient Outcomes
Peter J. Weiden, MD
Professor of Psychiatry
Department of Psychiatry
Director, Schizophrenia Research Program
SUNY Downstate Medical Center
Brooklyn, New York

Registration

To register, please call 1-888-717-2800 or e-mail Rebecca Ryen at rryen@scimedny.com.

Commercial Supporter:
This activity is supported by an educational grant from Bristol-Myers Squibb and Otsuka America Pharmaceuticals.

Accreditation

SciMed designates this educational activity (Universal Program Number 440-000-07-001-L01) for 1.5 contact hours (0.15 CEUs). No partial credit will be given.

Title: Maximizing Benefit Using New Treatment Approaches for Patients with Schizophrenia

Location: The Broadmoor, Colorado Hall A/B/C

Program Description:
Current options for schizophrenia treatment are limited. There is a need for developing improved therapies and better disease-management strategies. In order to do this, antipsychotic drug development must capitalize on advances in the understanding of differences among agents in pharmacodynamic effect, the influence that pharmacokinetics has on clinical effect, and the role of emerging technology in drug delivery systems for improving patient care.

All currently marketed antipsychotics have some effect on dopamine receptors. Of interest are the differences among agents in receptor occupancy and kinetics and how this impacts the relationship between pharmacodynamic effect and clinical outcome. These differences may have particular impact on risk for relapse and adverse effects. Development of single isomers and metabolites of currently marketed antipsychotics also challenge the clinician to identify differences among these agents that are meaningful to patient care.

The development of novel antipsychotic dosage forms has led to improvements in the clinical care of patients with schizophrenia. Formulations in development include extended-release oral agents, long-acting injections, and the use of nanotechnology for improved adherence, tolerability, patient acceptance and patient outcome.

Nonadherence and relapse are common clinical challenges faced by health care professionals managing schizophrenic patients. Medication-related factors such as adverse effects or inconvenient regimens may cause nonadherence. Medications that address issues of dosing inconvenience and excessive adverse effects, but maintain effect on the core symptoms of schizophrenia will be welcome therapeutic additions.

Please join us for a provocative, interactive presentation that will move from bench to bedside to explore evolving treatments for schizophrenia.

Educational Objectives:
At the conclusion of this program, the clinician will be able to:

• Outline a therapeutic plan integrating novel schizophrenia treatment options with traditional therapies.
• Delineate important advances in the development of treatments for schizophrenia as well as the therapeutic needs that are still unmet.
• Describe pharmacokinetic and pharmacodynamic considerations important in formulating a drug delivery system that might offer advantages in the management of patients with schizophrenia.
• Anticipate the impact of the pharmacokinetic and pharmacodynamic properties of various antipsychotic agents.
• Implement strategies for improving adherence in the nonadherent patient with schizophrenia using information from the most current literature on drug technology, delivery systems, and formulations.

Target Audience
Psychiatric pharmacy specialists and other clinicians attending the College o Psychiatric and Neurologic Pharmacists’ 10th Annual Meeting, who have an interest in learning more about novel formulations for the treatment of schizophrenia.

Faculty

Larry Ereshefsky, PharmD, BCPP, FCCP – Program Chair
Executive Vice President & Chief Scientific Officer
California Clinical Trials, a Division of Parexel International
Glendale, CA

Philip G. Janicak, MD
Professor of Psychiatry
Rush University
Chicago, IL

Roger W. Sommi, PharmD, BCPP, FCCP
Professor
Schools of Pharmacy and Medicine
University of Missouri-Kansas City
Kansas City, MO

Agenda

4:00-4:15 PM	Registration/Seating
4:15-4:25 PM	Welcome & Introductions Larry Ereshefsky, PharmD, BCPP, FCCP (Program Chair)
4:25-4:50 PM	New Possibilities in Understanding Antipsychotic Mechanism of Action Larry Ereshefsky, PharmD, BCPP, FCCP
4:50-5:15 PM	The Interface of Antipsychotic Drug Delivery and Drug Action Roger W. Sommi, PharmD, BCPP, FCCP
5:15-5:45 PM	The Clinician’s Perspective Philip G. Janicak, MD
5:45-6:00 PM	Panel Discussion

Registration

Pre-registration is not required but is suggested. As a pre-registrant, we will reserve seating for you until 5 minutes prior to starting the program. After that time, we will begin accepting walk-in registrants. There is no registration fee for this program.

Three convenient ways to register:

Fax	859-276-6118
Phone	Toll-free 866-360-1717 ext. 100
Website	www.ceconcepts.net/cpnp

Commercial Supporter:
Supported by an educational grant from Janssen, L.P. administered by Ortho-McNeil Janssen Scientific Affairs, LLC.

Accreditation

Creative Educational Concepts, Inc. (CEC) is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This program has been assigned ACPE # 245-000-07-011-L01 and will award 1.5 contact hours (0.15 CEUs) of continuing education credit. CEC complies with the Criteria for Quality for continuing education programming. Statements of credit will be issued to those participants attending the program and completing a CE request form and will be mailed within 10 business days.

Presented by Creative Educational Concepts

Title: "Effectiveness" as a Driver of Change: Impact of Antipsychotic Trials on Policy and Practice.

Location: The Broadmoor Hotel, Colorado Hall A/B/C

Program Description:
The past year has seen a plethora of headlines related to "effectiveness" studies and the use of antipsychotics. Data from the CATIE and CUtLASS studies have created confusion among clinicians. The evolving focus on effectiveness as an amalgamation of multiple components of drug therapy is a deviation from the historical FDA focus on efficacy and safety, concepts many clinicians are comfortable using for clinical decision-making. There is a demonstrated need for providing psychiatric pharmacists, many of whom develop practice guidelines, formularies, and treatment policy, with fair-balanced education on the key findings of these studies and the considerations necessary for interpretation and application into their practice. Join us to better understand how effectiveness translates into real-world care as an interactive panel discusses provocative questions on this topic.

Educational Objectives:
At the conclusion of this program, the clinician will be able to:

• Outline the major findings of effectiveness drug trials in psychiatry, including the CATIE Schizophrenia, CUtLASS, CATIE-AD, and Agency for Healthcare Research and Quality report on atypical antipsychotics.
• Interpret clinical and statistical considerations for design of effectiveness drug trials in psychiatry.
• Discuss the clinical and policy ramifications of effectiveness trials in the public and private practice settings.

Target Audience:
Psychiatric pharmacy specialists and other clinicians attending CPNPs' 10th Annual Meeting.

Faculty

Program Chair:
Roger W. Sommi, PharmD, BCPP, FCCP
Professor
Schools of Pharmacy and Medicine
University of Missouri-Kansas City
Kansas City, MO

Speaker/Discussant:
Jonathan P. Lacro, PharmD, BCPP, BCPS
Clinical Pharmacy Specialist in Psychiatry
VA Medical Center
Associate Clinical Professor of Psychiatry
University of California, San Diego
San Diego, CA

Speaker/Discussant:
Robert L. Dufresne, PhD, PhD, BCPP, BCPS
Professor of Pharmacy
University of Rhode Island College of Pharmacy
Kingston, RI
Psychiatric Pharmacotherapy Specialist
Providence VA Medical Center
Providence, RI

Panel Discussant:
Daniel Dugan, PharmD, BCPP
Kaiser Permanente
Arvada, CO

Panel Discussant:
Gene Makela, PharmD, BCPP
West Virginia University
Morgantown, West Virginia

Agenda

7:00-7:30 AM	Registration and Seating/Breakfast
7:30-7:35 AM	Welcome & Introductions Roger W. Sommi, PharmD, BCPP, FCCP (Program Chair)
7:35-8:05 AM	Important Findings of Effectiveness Drug Trials in Psychiatry Jonathan P. Lacro, PharmD, BCPP, BCPS
8:05-8:30 AM	Effectiveness Trials: Methods, Analysis, and Interpretations Robert L. Dufresne, PhD, PhD, BCPP, BCPS
8:30-9:00 AM	Interactive Panel Discussion: Clinical and Policy Ramifications of Effectiveness Trials Panel Discussants

Registration

Pre-registration is not required but is suggested. As a pre-registrant, we will reserve seating for you until 15 minutes prior to starting the program. After that time, we will begin accepting walk-in registrants. There is no registration fee for this program.

Three convenient ways to register:

Phone	Toll-free 866-360-1717 ext. 100
Fax	859-276-6118
Website	www.ceconcepts.net/cpnp

Commercial Supporter

Supported by an educational grant from Eli Lilly and Company

Accreditation

Creative Educational Concepts, Inc. (CEC) is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This program has been assigned ACPE # 245-000-07-012-L01 and will award 1.5 contact hours (0.15 CEUs) of continuing education credit. CEC complies with the Criteria for Quality for continuing education programming. Statements of credit will be issued to those participants attending the program and completing a CE request form and will be mailed within 10 business days.

Presented by Creative Educational Concepts

Title: This symposium will examine the underlying neurocircuitry of the arousal spectrum and discuss the consequences of sleep/wake symptoms associated with neuropsychiatric illnesses. An overview of the residual symptoms of mood disorders, in particular, will set the stage for the second talk which will highlight the importance of recognizing the residual symptoms of depression or anxiety mediated by sleep/wake circuitry. Discussion of the STAR*D augmentation trial (and others) will be used to illustrate the prevalence and impact of suboptimal treatment for depression, followed by a brief discussion of depressive subtypes (e.g., anxious vs. anergic). To conclude, there will be an overview of the treatment options for augmentation (especially sleep/wake disorders) from evidence-based and eminence-based perspectives. Options for the management of anergia, sleepiness, anhedonia, residual anxiety and insomnia will be discussed (including dosing, relevant adverse effects and interactions).

Educational Objectives:
At the conclusion of this educational activity, participants should be better able to:

• Discuss the neuronal circuits involved not only in the normal sleep/wake cycle, but also in disorders of sleep and wakefulness.
• Understand that disorders of sleep and wakefulness are not only characterized by problems with arousal, but also by dysfunction of attention and problem solving.
• Recognize the residual symptoms of depression or anxiety mediated by sleep/wake circuitry and review treatment options to achieve remission.

Faculty

Patrick R. Finley, Pharm.D., BCPP, Chairman
Professor of Clinical Pharmacy
Psychopharmacology and Behavioral Health
Department of Clinical Pharmacy
University of California at San Francisco School of Pharmacy, San Francisco, CA

Thomas L. Schwartz, M.D.
Associate Professor, Psychiatry and Behavioral Sciences
SUNY Upstate Medical University, Syracuse, NY

Agenda

12:40-1:10 p.m.	Registration and Lunch
1:10-1:15 p.m.	Introduction
1:15-1:50 p.m.	Understanding Sleep/Wake Circuitry in the Management of Mood Disorders
1:50-2:25 p.m.	The Role of Sleep/Wake Circuitry in Optimizing the Treatment of Mood Disorders
2:25-2:40 p.m.	Panel Discussion

Registration

Please include name, credentials, address, phone, fax and email.

Phone	(888) 535-5600
Fax	(760) 931-8713

Commercial Supporter:
This activity is supported by an educational grant from Cephalon Inc.

Accreditation

1.5 (0.15) Hours of ACPE Credit will be provided through CPNP as an accredited ACPE provider.