Industry Symposia

Sunday, April 19, 2009: 12:15 – 2:15 PM

Predicting Response to Antipsychotics in Patients with Schizophrenia: Applying Trial Data to the Clinical Setting

Schizophrenia is a disease that uniformly affects 1% of the world’s population. It is associated with a significant and disproportionate amount of disability and healthcare costs.1 It is a chronic, life long, debilitating disorder that is arguably one of the most challenging disorders that can impact an individual.

Antipsychotics remain the mainstay of treatment for schizophrenia. Current treatment guidelines for the management of schizophrenia suggest antipsychotic drug trials of 4 to 8 weeks to determine the benefit of therapy.1 Unfortunately, some individuals may not respond to initial treatment and require multiple trials of antipsychotic agents to achieve relief of their symptoms. This may result in a prolonged period of time and loss of function before a patient is initiated on a regiment that provides optimal therapeutic benefit. Strategies that improve a clinician’s ability to determine response to antipsychotic medication can enhance patients’ quality of life, limit patient exposure to medication therapy that is unlikely to benefit the patient, and may improve the cost effectiveness of antipsychotic treatment.

While full effect of antipsychotic therapy may take weeks or even months to realize, new evidence is showing that clinical effects may be evident as early as one day after the start of treatment.2-6 This opens the door for clinicians to begin identifying individuals who are not likely to respond to treatment and to switch antipsychotic agents sooner than traditionally thought feasible. Allowing providers to be more responsive may minimize the significant impact of ongoing “untreated” disorder and disability. A live, interactive presentation will be conducted during the symposium that will incorporate clinical assessment and treatment decision-making experiences. Expert speakers will review recent data that explores the concept of “early” versus “delayed” onset of action with antipsychotic agents. Audience response keypads will be used to encourage participation and to enhance learning.

1Lehman AF, et al. Am J Psychiatry. 2004. 2Agid O, et al. J Psychiatry Neurosci. 2006. 3Leucht S, et al. Schizophr Res. 2008. 4Kapur S, et al. Am J Psychiatry. 2005. 5Kinon BJ, et al. Schizophr Res. 2008. 6Ascher-Svanum H, et al. Schizophr Bull. 2007.

Faculty

Matthew A. Fuller, PharmD, BCPS, BCPP
Moderator/Chair
Clinical Pharmacy Specialist, Psychiatry
Louis Stokes Veterans Affairs Medical Center
Associate Clinical Professor of Psychiatry
Case Western Reserve University
Cleveland, OH

Deanna L. Kelly, PharmD, BCPP
Associate Professor of Psychiatry
Acting Director and Chief, Treatment Research Program
Maryland Psychiatric Research Center
University of Maryland School of Medicine
Baltimore, MD

John M. Kane, MD
Chief of Staff & Chairman, Dept. of Psychiatry
The Zucker Hillside Hospital
Dr. E. Richard Feinberg Chair in Schizophrenia Research
Professor of Psychiatry, Neurology, and Neuroscience
Albert Einstein College of Medicine
Bronx, NY

Additional Information

Monday, April 20, 2009: 11:15 AM – 1:15 PM

Novel Approaches in the Treatment of Generalized Anxiety Disorder: Case Studies in Clinical Practice

Anxiety disorders are the most common mental illness in the United States. An estimated 40 million (18%) of the adult U.S. population suffers from some type of anxiety disorder. Of those, approximately 6.8 million are affected by generalized anxiety disorder, making it the second most common mental health diagnosis in primary care practice.1,2 Generalized anxiety disorder (GAD) is defined by the American Psychiatric Association as “a feeling of excessive worry that is difficult to control and lasts for at least 6 months.”3 In addition, to fit the DSM-IV criteria, patients must also have experienced three physical complaints on more days than not. These complaints may include muscle tension, irritability, feelings of being “keyed up,” fatigue, and difficulty sleeping.3

A recent study found that anxiety disorders cost in excess of $42 billion annually. This is almost one-third of the total healthcare cost for all mental illnesses.1 This fact is supported by the finding that patients suffering from GAD are 1.6 times more likely than other primary care patients to be seen by their primary care physician at least four times in a year.2

Although anxiety disorders are prevalent, response and remission rates are relatively low.4 Traditional treatment consists of either an SSRI, an SNRI, or a benzodiazepine. Response rates with these medications ranged from 40% to 70% in studies where treatment lasted 2 to 6 months.5-8 Only about half of those who responded to treatment in one study remained in remission.9 Further, treatment with benzodiazepines can create additional issues associated with abuse/dependence potential.

There remains an unmet clinical need to treat refractory patients who fail to respond to current typical pharmacologic treatments and for patients who are unable to tolerate the adverse effects of currently available antidepressants. Join us to review case studies that will examine evidence-based therapies for GAD, as well as those on the horizon.

1Anxiety Disorders Association of America. 2Wittchen HU, et al. J Clin Psychiatry. 2002. 3APA DSM-IV. 4Koponen H, et al. J Clin Psychiatry. 2007. 5Davidson JR, et al. Depress Anxiety 2004. 6Gelenberg AJ, et al. JAMA. 2000. 7Rickels K, et al. Arch Gen Psychiatry. 1993. 8Pollack MH, et al. J Clin Psychiatry. 2001. 9Pollack MH. Psychopharmacol Bull. 2004.

Faculty

Cynthia K. Kirkwood, PharmD, BCPP
Activity Chair
Associate Professor of Pharmacy
Vice Chair for Education
Virginia Commonwealth University
Richmond, VA

David J. Muzina, MD
Director, Center for Mood Disorders Treatment and Research
Associate Professor of Medicine
Cleveland Clinic Neurological Institute, Psychiatry & Psychology
Cleveland, OH

Robert M. Post, MD
Clinical Professor of Psychiatry
George Washington University
Bipolar Collaborative Network
Bethesda, MD

Additional Information

Monday, April 20, 2009: 4:00 – 6:00 PM

Improving Adherence in Schizophrenia Across the Health Care Spectrum: Best Practices

This session will feature a diverse panel of psychiatric pharmacy clinicians discussing medication adherence and continuity of care in the schizophrenia patient who transitions through the health care system and demonstrates nonadherence with therapy. Presentations will be case-based and utilize audience response technology to provide interactive learning for participants. Faculty will engage the audience in a lively panel discussion about the impact of medication adherence and continuity of care in their specific practices and offer suggestions to improve the pharmacologic and nonpharmacologic treatment outcomes.

Faculty

Jonathan P. Lacro, PharmD, BCPS, BCPP
(Moderator/Chair)
Clinical Pharmacy Specialist in Psychiatry
Director of Pharmacy Education and Training
VA San Diego Healthcare System
Associate Clinical Professor of Psychiatry
University of California, San Diego
San Diego, CA

Christopher J. Thomas, PharmD, BCPP, BCPS, CGP
Clinical Pharmacy Specialist in Psychiatry
Veterans Affairs Medical Center
Chillicothe, OH
Assistant Professor of Pharmacology
Ohio University College of Osteopathic Medicine
Athens, OH

Kelly N. Gable, PharmD, BCPP
Assistant Professor, Dept. of Pharmacy Practice
Southern Illinois University Edwardsville School of Pharmacy
Edwardsville, IL
Psychiatric Clinical Pharmacist
Community Alternatives
St. Louis, MO

Eric C. Kutscher, PharmD, BCPP
Associate Professor, Dept. of Pharmacy Practice
South Dakota State University College of Pharmacy
Clinical Pharmacy Specialist, Psychiatry
Avera Behavioral Health Center
Sioux Falls, SD

Additional Information

Tuesday, April 21, 2009: 7:00 – 9:00 AM

Practical Seizure & Epilepsy Management: Special Considerations Across the Lifespan

Epilepsy and seizures affect 2.7 million American children, adolescents, and adults with 200,000 new cases occurring each year. One in every 10 Americans will experience a seizure in their lifetime and 3 in every 100 will develop a chronic seizure condition.1 Epilepsy poses a significant financial burden to both the patient and to society. The direct and indirect costs of epilepsy approach $13 billion each year.2

Epilepsy is strongly associated with psychological and social consequences that negatively affect a patient's daily life. Because epilepsy is a "hidden" disability, patients are among the most vulnerable in our society because of both the condition itself and the societal stigma associated with it.3

Treatment of seizures is often complex; despite a number of available anticonvulsant therapies, 30% of patients continue to have seizures and/or have significant drug side effects.4 This is complicated by the fact that seizure occurrence is most prevalent in the very young and the very old. Use of medications in these populations presents a challenge because of their unique pharmacokinetic profiles. However, new agents are on the horizon that may improve treatment response and success.

The diagnosis and management of seizures and epilepsy is a complex task that requires a great deal of vigilance. Factors that present challenges include AED safety, patients with co-morbid diseases, women of child-bearing age who may become pregnant, patients who have received generic substitution or therapeutic substitution, and those who are refractory to treatment. Novel antiepileptic agents are on the horizon which may augment treatment options for the clinician managing the epilepsy or seizure patient.

Join us for an interactive symposium that incorporates video vignettes, applicable cases, and emerging clinical information to assist in your care of the seizure patient.

1Epilepsy Foundation. 2World Health Organization. 3Baker GA. Epilepsia. 2002. 4Smith PEM, et al. Clin Med. 2004.

Faculty

Melody Ryan, PharmD, MPH, BCPS, CGP (Activity Chair)
Associate Professor
Departments of Pharmacy Practice and Science and Neurology
University of Kentucky
Lexington, KY

Steve S. Chung, MD
Director, Neurology Residency Program,
Epilepsy Monitoring Unit, and Clinical Epilepsy Research
Barrow Neurological Institute
Phoenix, Arizona

Additional Information

Tuesday, April 21, 2009: 12:00 – 2:00 PM

Managing the Spectrum of Psychiatric Disorders in Children and Adolescents: Evidence-Based Use of Atypical Antipsychotics

Faculty

Julie Dopheide, PharmD, BCPP (CPNP Chair)
Associate Professor
Clinical Pharmacy and Pharmaceutical Economics and Policy
School of Pharmacy
University of Southern California
Los Angeles, California

Robert A. Kowatch, MD
Professor of Psychiatry and Pediatrics
Director, Pediatric Mood Disorders Center
Cincinnati Children's Hospital Medical Center
Cincinnati, Ohio

Christoph U. Correll, MD
Medical Director, Recognition and Prevention (RAP) Program
Director, Adverse Events Assessment and Prevention Unit
Advanced Center for Intervention Services and Research
The Zucker Hillside Hospital
Center for Translational Psychiatry
The Feinstein Institute for Medical Research
North Shore-Long Island Jewish Health System
Associate Professor of Psychiatry and Behavioral Sciences
Albert Einstein College of Medicine
Bronx, New York

Additional Information