Highlights from ECNP 2022

Unite to act on depression

“It’s not surprising that the latest Lancet commission is devoted to a united action – a Call to Arms – to better treat and prevent disability relating to depression.” – Professor Raymond Lam, Vancouver, Canada

Several industry symposia focused on multiple aspects of care for patients with depression and comorbid anxiety, given that:

• Depression is a leading cause of avoidable suffering in the world affecting an estimated 322 million people globally¹ with huge economic consequences for governments.
• The COVID-19 pandemic has led to an increase in anxiety and of major depressive disorder (MDD) of >25% in 2020, prompting the Lancet and World Psychiatric Association to call for ‘United Action on Depression’.^2,3

Restoration of functioning is a patient-driven goal of MDD treatment

“Patients consider functioning as the main goal of treatment of depression, to help them return to a full work, family and social life.” – Professor Andrea Fagiolini, Siena, Italy

• The need for effective treatments that lead to full functional recovery was identified in the symposia, reflecting the burden of MDD on both the individual and society.
• Patients want to achieve functional recovery in MDD, with treatments that help to lift their mood and allow them to return to a full work, family and social life.

Act early to optimize treatment response in MDD

“We have to be vigilant to detect intolerance, partial insufficient response and illness recurrence in MDD. The earlier we make these detections, the more successful the outcome is going to be.” – Professor George Papakostas, Boston, USA

• Early assessment and identification of partial response is critical in improving treatment outcomes for patients with MDD.
• Recent research in patients with MDD with a history of suboptimal response to the most commonly used antidepressants was presented with consideration of the effect on depressive symptoms, tolerability, functioning and other patient outcomes.
• A review of guidelines demonstrated the clinical effectiveness and optimal timing of management strategies for patients with inadequate response, such as increasing the antidepressant dose, switching to a different antidepressant or augmentation.

Managing comorbid depression and anxiety to achieve full functional outcomes

• Anxiety disorders, including generalized anxiety disorder (GAD), are frequently co-morbid with MDD and amplify the detrimental impact on functioning and increase burden of disease for these patients.
• Recent evidence was presented on the impact of selected antidepressants in patients with MDD and GAD to significantly improve functional outcomes and quality of life (QoL).

“We are starting to see treatments specifically for patients with comorbid depression and anxiety that are effective in terms of improving not only disease symptoms, but also ability to function and quality of life.” – Professor Andrea Fagiolini, Siena, Italy

Beyond symptom control in schizophrenia

Schizophrenia was the subject of symposia focused on optimizing long-term therapy use and the patient perspective on setting treatment goals

• Treatment goals in schizophrenia should go beyond symptom control to promote clinical improvement, functional recovery, better health-related QoL and attainment of patient’s personal life goals.⁴
• The importance of developing a long-term maintenance treatment plan that minimizes the risk of relapse and addresses residual symptoms was identified.
• Tailoring treatment goals to the needs and preferences of individuals was emphasized and communication techniques, such as shared decision-making and motivational interviewing, help to engage patients and can improve treatment acceptance and adherence.

“Shared decision-making is key essential, and clinician’s approaches may work even better in a scenario in which patients share their expertise, as they really know what the disease is about.” – Professor Stephan Heres, Munich, Germany

Plenary lecture

Professor Bita Moghaddam presented research focused on understanding the neuronal basis of complex behaviors that are critical to mental health. She highlighted advances in the use of animal models to improve treatment of schizophrenia. Her work has contributed to the discovery of compounds targeting metabotropic glutamate receptors for schizophrenia treatment.