Depression Assessment and Treatment

This online course is designed to provide instruction on the assessment and treatment of depression including suicide risk. Instruction on the mental status examination is provided along with guidance on when to refer patients for further evaluation. A comprehensive review of treatment options including psychotherapeutic and complementary treatments is presented. Participants will be asked to apply knowledge and skills to diverse cases of depression.

Target Audience: Pharmacists interested in the assessment and treatment of patients with depressive symptoms and medical comorbidities.

Goals: To provide pharmacists with the knowledge and skills needed to assess and treat patients with depressive symptoms and medical comorbidities.

Credit: Earn 5 hours of continuing education credit

Program Objectives
At the completion of this activity, the participant will be able to:
1. Detect signs and symptoms of depression through evaluation of a patient’s appearance, behavior, mood, emotional expression, thought process, and content.
2. Employ appropriate descriptors in documenting components of the mental status examination in a patient progress note.
3. Differentiate provider behaviors that may be effective in establishing a therapeutic alliance from behaviors not conducive to establishing a therapeutic alliance.
4. Discuss the epidemiology of major depression and its impact on health outcomes including diabetes and heart disease.
5. Compare the patient health questionnaire (PHQ-9) to other assessment tools for major depression (e.g. Hamilton Depression Rating Scale, and Beck Depression Inventory) with regard to ease of use and diagnostic validity.
6. Formulate questions to illicit suicide risk factors in patients who present with depressive symptoms.
7. Classify depressive symptoms according to those most responsive to pharmacotherapy and those that respond better to nonpharmacological treatments.
8. Given a patient vignette, judge when symptoms warrant referral to a specialist for further evaluation and treatment.
9. Describe the pathophysiology of major depression and explain brain changes and clinical course to a patient and their family members.
10. Compare psychotherapeutic treatment options for major depression and explain the benefits of treatment to a perspective patient.
11. Explain the significance of neuropsychiatric comorbidities (e.g., PTSD, anxiety, pain, persistent insomnia, and substance use disorders) on the treatment and course of major depression.
12. Appraise the role of complementary therapeutics such as fish oil, SAM-E, and St. John’s Wort in the management of major depression.
13. Explain the role of atypical antipsychotics, lithium, triiodothyronine, electroconvulsive therapy and ketamine in the management of major depression.
14. Distinguish clinically significant differences among SSRIs with regard to dosing, tolerability, and drug interactions.
15. Differentiate trazodone, vilazodone and vortioxetine from each other with regard to receptor pharmacology, dosing, tolerability, and drug interactions.
16. Compare TCAs to SNRIs with regard to safety, dosing, tolerability, monitoring and drug interactions.
17. Determine the place in therapy of bupropion, mirtazapine, and milnacipran in the management of major depression and recommend optimal dosing and monitoring of each.