Section - Quick Takes

03. The Clinical Effectiveness of Sertraline in Primary Care and the Role of Depression Severity and Duration (PANDA): A Pragmatic, Double-Blind, Placebo-Controlled Randomized Trial – Part 1

Published on November 1, 2022 Certification expiration date: November 1, 2028

James Phelps, M.D.

Research Editor - Psychopharmacology Institute

Key Points

A debate is growing (raging?) regarding the benefit–risk ratio of antidepressants, with some voices calling for a dramatic decrease in their use, at least in primary care.
In a study of depression in primary care, sertraline was not superior to placebo.
Among secondary outcome measures, sertraline did lower anxiety scores more than placebo.
Now for the rebuttals (next Quick Take, Part 2)…

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Because I entered psychiatry as a second-year resident, I had to do inpatient work for a year straight, up all night every third night. You might remember that drill if you’re old enough. By December, I was gloomy and irritable. And when a third person said, “You should consider an antidepressant,” I started fluoxetine. Amazing. In a week, my mood was definitely better. I didn’t resent my colleagues as much, and my attending said suddenly I’d become much smarter. And yet, a debate is brewing that invites us to wonder whether SRIs and SNRIs work well enough to justify their risks. Have we been wrong for 30 years?

Hi! Jim Phelps here for the Psychopharmacology Institute. Here’s an article that sits in the middle of that controversy. Of course, 1 study doesn’t settle a debate. Better would be a meta-analysis of multiple studies. Better yet, a meta-analysis of meta-analyses, and

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04. Estimates of the Minimal Important Difference to Evaluate the Clinical Significance of Antidepressants in the Acute Treatment of Moderate-To-Severe Depression – Part 2

Learning Objectives:

After completing this activity, the learner will be able to:

Examine treatment guidelines and a recent meta-analysis regarding the efficacy of lithium as a treatment for bipolar depression in comparison to quetiapine.
Compare the rate of benign rash in patients whose lamotrigine dose was titrated using standard titration rates vs those whose lamotrigine dose was titrated using the slower titration rates.
Evaluate the efficacy of sertraline, relative to placebo, for the treatment of depression in primary care.
Compare the efficacy of antidepressants in the treatment of depression using the concept of minimal clinically important difference (MICD).
Evaluate a randomized trial of omega-3 fatty acids as adjuncts for venlafaxine, as well as meta-analyses of omega-3 efficacy for the treatment of depression and anxiety.

Original Release Date: November 1, 2022

Review and Re-release Date: November 1, 2025

Expiration Date: November 1, 2028

Expert: James Phelps, M.D.

Medical Editor: Melissa Mariano, M.D.

Relevant Financial Disclosures:

None of the faculty, planners, and reviewers for this educational activity have relevant financial relationships to disclose during the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Contact Information: For questions regarding the content or access to this activity, contact us at support@ml-staging.psychopharmacologyinstitute.com

Instructions for Participation and Credit:

Participants must complete the activity online during the valid credit period that is noted above.

Follow these steps to earn CME credit:

View the required educational content provided on this course page.
Complete the Post Activity Evaluation for providing the necessary feedback for continuing accreditation purposes and for the development of future activities. NOTE: Completing the Post Activity Evaluation after the quiz is required to receive the earned credit.
Download your certificate.

Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation Statement

Medical Academy designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.