Highlights of the 168th American Psychiatric Association Annual Meeting: A Focus on Bipolar Disorder

May 16, 2015
Philip R. Muskin, MD

From the treatment of mood and anxiety disorders in pregnant and nursing women to the effects of antidepressants and anti-inflammatory agents on older adults with stress and mood disorders, APA is a great opportunity to learn state-of-the-art information on bipolar disorder.

Dr Muskin is Professor of Psychiatry at Columbia University Medical Center and Chief of Service: Consultation-Liaison Psychiatry at New York-Presbyterean Hospital/Columbia University Medical Center in New York. He is an editorial board member of Psychiatric Times.

At first glance, it may not look like there’s much happening with bipolar disorder at this year’s American Psychiatric Association meeting, but there is actually so much. Within a particular session, there may be quite a bit about bipolar disorder-you just need to dig a little deeper to find it.

Here are a few that stand out. On the 17th, Carlos Zarate is giving the Simon Bolivar award lecture, “An Update on the Treatment and Research of Treatment-Resistant Depression and Bipolar Disorder.” One of the things he’ll talk about is the use of ketamine as a possible tool to identify biomarkers for treatment response.

In addition, there are two other talks on the 17th that should be fantastic. Alan Schatzberg will present “An Update on Antidepressant Treatment: Pharmacogenetics, Rapidly Acting Agents, and Brain Stimulation.” As you can see by the title, it’s not just an update. Alan is going to talk about pharmcokinetics, brain stimulation, and the new field of rapidly acting agents such as ketamine or ketamine analogs.

Helen Mayberg has several presentations. She’ll be joining the conversation on science, advocacy, and mental health during the Opening Session on Sunday the 17th. Later that day she’s chairing an interactive session, “Reflections on a Decade of Research Investigating Deep Brain Stimulation for Depression.” On the 19th, she and her colleagues will talk about neurocognitive predictors of response in treatment-resistant depression.

On the 18th, Jerry Rosenbaum who is the Chair at the Massachusetts General Hospital , will be giving a talk that’s targeted at what we all struggle with clinically: “What to Do While Waiting for Better Antidepressant Treatments.”

On the 19th, Sarah “Holly” Lisanby, who is the Chair at Duke, and is really an ECT radio-imaging guru, is going to talk about seizure therapy for depression. She’s going to be talking about translational development of magnetic seizure therapy and how it can improve safety and focality of seizure therapy-but what she calls it is, Teaching an Old Dog Some New Tricks.

As you’ll see for yourself at the meeting, we’re really trying to stay on the cutting edge of science and provide a glimpse into the future. And at the same time, as we always do at APA, we try to provide clinicians with practical material that they can use in their practice.

There’s a bit more science on the 18th with Roger McIntyre’s symposium with the catchy title of “From Neuron to Neighborhood: An Update on Contemproary Models for Disease Pathogenesis, Clinical Characterization, and Treatment of Bipolar Disorder,” which will provide a clinically relevant understanding of contemporary pathogenic models of bipolar disorder.

Also on the 18th, Julio Licinio, who’s a former Program Chair and the editor of Molecular Psychiatry, will be presenting “Depression and Obesity: The Clinical and Research Interface of Two Modern Diseases.” The talk is on the clinical interrelationship between obesity and depression, how one can cause the other-I really expect this to be fantastic.

For many years, there’s been an interest about the connection between inflammatory disease and depression. We now have a better sense that the two are connected in some way-we’re not there yet, but we are getting closer. Bernhard Baune and Roger McIntyre are going to be talking about “Beyond Inflammation. Diverse Immune and Metabolic Dysfunctions in Clinical Depression.” Here is just some of what they will cover: dynamic phase-specific model of immune dysfunction in depression, the neurobiology of chemokines in depression, and immune inflammatory mechanisms relevant to the treatment and prevention of brain disorders. Helen Lavretsky of the David Geffen School of Medicine at UCLA will join the conversation with a talk on the effects of antidepressants and anti-inflammatory agents on older adults with stress and mood disorders. And, on the other side of the age spectrum, Benjamin Goldstein will be talking about inflammation as a putative biomarker for mood and cognition in adolescents with bipolar disorder.

A few other sessions that people may not want to miss-and remember, I’m looking at 30 sessions, but only pointing a few out-quite frankly, there are so many. At 1 pm on the 16th, there’s a session on melatonin and light treatment for seasonal affective disorder by Alfred Lewy. And, there’s “A Psychodynamic Approach to Treatment-Resistant Mood Disorders” that Eric Plakun is presenting on the 19th.

Two other sessions that I think are worth mentioning are: first, Florian Holsboer’s presentation on the 17th. He’s one of our international speakers, and he is going to be talking about something that everybody wants to hear about, the future of antidepressant drug discovery. And, at 9 am on the 16th Charles Nemeroff will be chairing a session on personalized medicine in mood and anxiety disorders. He’ll be joined by Alan Schatzberg, Kerry Ressler, Phil Harvey, Helen Mayberg, and Ned Kalen. This, I think, is a really very hot topic.

I should mention one of my own sessions. On Sunday the 17th, my colleagues and I are presenting (we try to do this every year) “Pearls of Psychosomatic Medicine.” We’re going to be talking about several different “hot” topics. We’ll start with a discussion of our role in bringing addiction treatment into medical settings by providing models of care. Then we’ll review QTc prolongation-one of the hottest topics this year-and its corrolation with Torsades de Pointes as well as how to manage a delirious patient with prolonged QTc. Then we’ll review the treatment of mood and anxiety disorders in pregnant and nursing women-there are many other sessions on this topic but this one is short and to the point. It’s always a good session and we really try to make it brief, to the point, take-home pearls; get there early, because the room is always packed!

And, last but not least, is Richard Kogan, professor of psychiatrist and concert pianist-he’s one of the top draws of every APA meeting. This year he’s talking about and playing Chopin. Chopin is not known to have had psychiatric illness, but based on his story it’s likely that he had a panic disorder as well as depression; although he probably died of tuberculosis. It’s a fascinating tale, with lots of tawdry parts in it, of one of the really the great composers of all times. The session will be a little different this year-it’s on Saturday evening at 5:30 and it will be in the theatre of the convention center, which holds approximately 2000 people; but, once again, get there early if you want to get a seat.

So this is as overview of an overview as I can possibly give you, and if I left someone or something out, it wasn’t on purpose. I really want everyone to have a great time and learn. I don’t think you should go to every single session from morning till night because you’ll go crazy. But I do think this is a great opportunity to meet friends and colleagues that you may not have seen for a while; to talk with new colleagues and perhaps make some unexpected new friends.

Of course the main purpose of our meeting is to learn, but it’s also to meet people from all over the world. You know, if you’re sitting in a meeting, while everything is getting going, why not say hello to the person who’s sitting next to you. Exchange cards. The next thing you know, that person’s from London and you’re emailing her, “how do I get a patient therapy who’s doing a semester at Oxford?” That’s what’s fantastic about the meeting. That you really have an opportunity to meet people, to share experiences with people.

Finally, I encourage everybody to download the APA Meeting app before they come to Toronto, so they don’t have to pay the extra charges. If you’re not in the hotel and getting free WiFi or you’re not in the convention center you might have to pay for it. Or if you have a United States phone and you don’t have an international plan, it’ll cost you. You can download it here: http://app.core-apps.com/tristar_apa15. You can put in your personal schedule and if there are any changes (date, time, venue) it updates automatically. Spend 20 minutes customizing it so you can quickly look at what you want to do and be ready. You can also publish your profile if you want to let people know that you are there.