Fact or Fiction? Test Your Knowledge on Residual and Treatment-Emergent Symptoms in Major Depressive Disorder

This activity has been designed to meet the educational needs of psychiatrists, advanced practice psychiatric nurses, and other mental health care professionals who care for individuals with major depressive disorder.


Supported by an educational grant from:

Takeda Pharmaceuticals U.S.A., Inc. and Lundbeck

Activity Information


Release date: June 18, 2019
Valid through: June 18, 2020
Estimated time to complete activity: 60 minutes
Media: Internet




Statement of Need/Program Overview

Although major depressive disorder (MDD) has a profound impact on individuals, families, and society, it remains undertreated. There are currently more than 4 million US adults who are inadequately treated for MDD. Numerous studies show that antidepressant therapies are superior to placebo, but most adults with MDD do not achieve an adequate response with first-line pharmacotherapy. Inadequate response to antidepressant therapy is associated with greater medical morbidity, more hospitalizations, decreased productivity, and more suicide attempts. Treatment of MDD should strive for return to premorbid status and full functional and cognitive recovery. However, survey data show that health care providers may lack confidence in the management of patients who have an inadequate response to an antidepressant. The major barriers to achieving full recovery are the continuation of residual symptoms and treatment-emergent symptoms associated with antidepressants. Even in those responding to antidepressants, residual and treatment-emergent symptoms such as weight gain, sleep disturbance, and sexual dysfunction can impede adherence and recovery. Additionally, poor cognitive functioning is an obstacle to remission. Although tools are available for the evaluation and monitoring of cognitive function in patients with MDD, they remain underutilized. In this enduring activity, expert faculty will provide opportunities to enhance knowledge and competence in the ability to differentiate residual and treatment-emergent symptoms and better assess and manage symptoms using evidence-based strategies to optimize available therapies.

Learning Goal/Purpose

The goal of this enduring activity is to enhance knowledge and competence in the recognition and management of residual and treatment-emergent symptoms, including cognitive impairment, to improve outcomes in patients with major depressive disorder.

Educational Objectives

After completing this activity, the participant should be better able to:

  • Implement strategies to recognize and manage residual symptoms in patients with MDD
  • Identify and manage cognitive impairment in patients with depression
  • Recognize treatment-emergent side effects of antidepressants such as sexual dysfunction, weight gain, and sleep disturbance


Anita H. Clayton, MD  
David C. Wilson Professor and Chair
Department of Psychiatry and Neurobehavioral Sciences
University of Virginia
Charlottesville, Virginia

Michael E. Thase, MD
Professor of Psychiatry
Department of Psychiatry
Mood and Anxiety Disorders Treatment and Research Program
Perelman School of Medicine - University of Pennsylvania
Philadelphia, Pennsylvania
Michael J. Crescenz VAMC
Philadelphia, Pennsylvania

Physician Credit

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Medical Education Resources (MER) and CMEology. MER is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation

Medical Education Resources designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nursing Credit

Medical Education Resources is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

This CE activity provides 1.0 contact hour of continuing nursing education.  Medical Education Resources is a provider of continuing nursing education by the California Board of Registered Nursing, Provider #CEP 12299.

Disclosure of Conflicts of Interest

Medical Education Resources ensures balance, independence, objectivity, and scientific rigor in all our educational programs. In accordance with this policy, MER identifies conflicts of interest with its instructors, content managers, and other individuals who are in a position to control the content of an activity. Conflicts are resolved by MER to ensure that all scientific research referred to, reported, or used in a continuing education activity conforms to the generally accepted standards of experimental design, data collection, and analysis. MER is committed to providing its learners with high-quality activities that promote improvements or quality in health care and not the business interest of a commercial interest.

The faculty reported the following financial relationships with commercial interests whose products or services may be mentioned in this activity:

Anita H. Clayton, MD  
Reported Financial Relationships
Consultant/Advisor for Acadia Pharmaceuticals Inc., Alkermes PLC, Allergan, Inc., AMAG Pharmaceuticals, Fabre-Kramer Pharmaceuticals, Inc., Lundbeck, Otsuka, Palatin Technologies, Inc., S1 Biopharma, Inc., Sage Therapeutics, Sprout Pharmaceuticals, Inc., Takeda Pharmaceutical Company; Research/Grant Support from Endoceutics, Inc., Janssen Pharmaceuticals, Inc., Sage Therapeutics, Takeda Pharmaceutical Company; Ownership Interest/Shareholder of Euthymics, S1 Biopharma, Inc; Royalty/Patent Holder of Ballantine Books/Random House, Changes in Sexual Functioning Questionnaire, Guilford Publications.

Michael E. Thase, MD
Reported Financial Relationships
Consultant/Advisor for Acadia Pharmaceuticals Inc., Akili, Alkermes PLC, Allergan, Inc. (Forest, Naurex), Cerecor, Inc., Fabre-Kramer Pharmaceuticals, Inc., Gerson Lehrman Group, Inc., Guidepoint Global, LLC, Johnson & Johnson (Janssen, Ortho-McNeil), Lundbeck, moksha8 Pharmaceuticals, Inc., Nestlé (Pamlab), Neuralstem, Inc., Novartis International AG, Otsuka Pharmaceutical Company, Ltd., Pfizer, Inc., Sage Therapeutics, Sunovion Pharmaceuticals Inc.; Research/Grant Support from Acadia Pharmaceuticals Inc., Agency for Healthcare Research and Quality (AHRQ), Alkermes PLC, Allergan, Inc. (Forest, Naurex), AssureRx Health, Inc., Avanir Pharmaceuticals, Inc., Axsome Therapeutics, Inc., Intracellular Therapies, Janssen Pharmaceuticals, Inc., Johnson & Johnson (Janssen, Ortho-McNeil), National Institutes of Health/National Institute of Mental Health (NIMH), Otsuka Pharmaceutical Company, Ltd., Patient-Centered Outcomes Research Institute (PCORI), Takeda Pharmaceutical Company.

The content managers reported the following financial relationships with commercial interests whose products or services may be mentioned in this activity:

Beth Goodwin (CMEology)
No financial relationships to disclose.

Rob Lowney (CMEology)
No financial relationships to disclose.

Dana Ravyn, PhD, MPH (CMEology)
No financial relationships to disclose.

MER content reviewers
No financial relationships to disclose.

Method of Participation

There are no fees for participating in and receiving credit for this activity. During the period TBD through TBD, participants must 1) read the learning objectives and faculty disclosures, 2) study the educational activity, 3) complete the posttest by recording the best answer to each question, and 4) complete the evaluation form.

A statement of credit will be issued only upon receipt of a completed activity evaluation form and a completed posttest with a score of 70% or better, with no more than 3 attempts.


The content and views presented in this educational activity are those of the authors and do not necessarily reflect those of Medical Education Resources, CMEology, and/or Takeda Pharmaceuticals U.S.A., Inc. and Lundbeck. The authors have disclosed if there is any discussion of published and/or investigational uses of agents that are not indicated by the FDA in their presentations. Before prescribing any medicine, primary references and full prescribing information should be consulted. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities. The information presented in this activity is not meant to serve as a guideline for patient management.

Fee Information

There is no fee for this educational activity.

MER Privacy Policy

Medical Education Resources maintains high standards for the protection of privacy over the Internet. The purpose of this statement is to explain what information we obtain, how it is used, and how visitors can restrict its use or disclosure.
The only information MER obtains is information supplied voluntarily by the visitor.
We do not sell or disclose individually identifiable information obtained online unless it is required by law or disclosure is necessary to protect the safety of customers, employees, or property.
We use the information to grade your posttest and to send you a certificate of completion of the activity. If we use a third-party company to grade your posttest and issue certificates of completion, we will give the information to that company for that purpose only.
For each activity that you take, you must complete an evaluation questionnaire. That questionnaire asks if you are willing to participate in a follow-up survey. If you answer yes, we will use your name and contact information to send you the survey.
We may use the information to invite you to participate in other activities that we may offer.
Medical Education Resources is committed to safeguarding customer privacy, and we require our employees to protect the privacy of information about our customers. Should you wish to delete your information from our files or discuss our privacy policy, please contact us (800-421-3756).

For questions about this activity, please contact CMEology at: [email protected].