December 2008 · Vol. 07, No. 12S

Diagnosing and managing psychotic and mood disorders

RELEASE DATE: DECEMBER 1, 2008
EXPIRATION DATE: DECEMBER 1, 2009

LEARNING OBJECTIVES

After reviewing this material, clinicians should be better able to:
• Achieve early and accurate diagnosis of patients with mood disorders
• Utilize available screening tools effectively
• Understand the mechanisms of action, hepatic effects, and other metabolic effects of available agents and their potential impact on treatment
• Develop an effective treatment plan that includes monotherapy or combination therapy
• Select the most appropriate agent(s) for short- and long-term treatment to meet individual patient needs

TARGET AUDIENCE
Psychiatrists, primary care physicians, and other health care professionals who treat patients with psychotic and mood disorders

CME ACCREDITATION
The University of Cincinnati designates this educational activity for a maximum of 4.0 AMA PRA Category 1 credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. This CME activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the sponsorship of the University of Cincinnati College of Medicine.
The University of Cincinnati College of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

FINANCIAL DISCLOSUR ES AND CONFLICTS OF INTEREST
According to the disclosure policy of the University of Cincinnati, faculty, editors, managers, and other individuals who are in a position to control content are required to disclose any relevant financial relationships with the commercial companies related to this activity. All relevant relationships that are identified are reviewed for potential conflicts of interest. If a conflict of interest is identified, it is the responsibility of the University of Cincinnati to initiate a mechanism to resolve the conflict(s). The existence of these interests or relationships is not viewed as implying bias or decreasing the value of the presentation. All educational materials are reviewed for fair balance, scientific objectivity of studies reported, and levels of evidence.

The faculty has reported the following:
• Dr Nasrallah reports that he is on the advisory board of Abbott, AstraZeneca, Cephalon, Janssen, Pfizer, and Vanda Pharmaceuticals; is a consultant for AstraZeneca, Janssen, Pfizer, and Vanda Pharmaceuticals; receives grants from AstraZeneca, Forest Laboratories, Janssen, Otsuka America Pharmaceutical Inc., Pfizer, Roche, and sanofi-aventis; and is on the speakers bureau of AstraZeneca, Janssen, and Pfizer.
• Dr Black reports that he is a consultant for Forest Laboratories and Jazz Pharmaceuticals and receives grant(s) from Forest Laboratories.
• Dr Goldberg reports that he is on the advisory board, speakers bureau, and serves as a consultant for AstraZeneca, Eli Lilly & Co, and GlaxoSmithKline.
• Dr Pariser reports that he receives grants from Pfizer and is on the speakers bureau of AstraZeneca, GlaxoSmithKline, and Pfizer.
• Dr Muzina reports that he is on the advisory board of AstraZeneca and Bristol-Myers Squibb; and is on the speakers bureau of AstraZeneca, Bristol-Myers Squibb, Pfizer, Sepracor, and Wyeth.

Planning Committee: Kay Weigand, University of Cincinnati; and Kristen Georgi, Charles Williams, and Katherine Wandersee for Quadrant HealthCom Inc. have disclosed no relevant financial relationship(s) with any commercial interests.

Off-label/unapproved agents discussed: Lithium, valproate, and carbamazepine are not approved by the FDA for the treatment of schizophrenia; lithium is not approved for the treatment of suicidality; topiramate, sibutramine, and metformin are not approved for the treatment of antipsychotic-induced weight gain; quetiapine is not approved for the treatment of generalized anxiety disorder; and venlafaxine is not approved for the treatment of obsessive compulsive disorder.

A list of FDA-approved drugs mentioned in this activity appears on page S31.

None of the atypical antipsychotic agents have been approved in the psychosis or agitation of dementia, and the FDA has issued a class-effect black-box warning regarding the increased mortality in geriatric patients treated with atypical antipsychotics compared to those treated with placebo.

ACKNOWLEDGEMENT
This CME activity was developed through the joint sponsorship of the University of Cincinnati and Quadrant HealthCom Inc.. It was edited and peer reviewed by Annals of Clinical Psychiatry and Current Psychiatry.

STATEMENT OF SUPPORT
This CME activity is supported by an educational grant from AstraZeneca.

Current Psychiatry ©2008 American Academy of Clinical Psychiatrists and Quadrant HealthCom Inc.