DEPRESSION CLINICAL AND RESEARCH PROGRAM
Outpatient Psychiatry Division, Massachusetts General Hospital
Maurizio Fava, M.D. (Program Director), Jonathan Alpert, M.D., Ph.D., Andrew Nierenberg, M.D. (Associate Directors), Joel Pava, Ph.D., Timothy Petersen, Ph.D., Amy Farabaugh, Ph.D., Jacqueline Buchin, Psy.D., David Mischoulon, M.D., Ph.D., Albert Yeung, M.D., Sc.D., John Worthington, M.D., Dan Iosifescu, M.D., Roy Perlis, M.D., Joyce Tedlow, M.D., Shamsah Sonawalla, M.D., Christina Dording, M.D., Paolo Cassano, M.D.
The Depression Clinical and Research Program seeks to evaluate the short-term and long-term efficacy of therapeutic strategies such as pharmacotherapy and cognitive therapy in unipolar depressive disorders such as major depression, minor depression, and dysthymia. In particular, an ongoing controlled study evaluates the possible synergistic effects of cognitive therapy and pharmacotherapy during maintenance treatment of recurrent or chronic major depression and a collaborative R-01 study assesses the efficacy of pharmacotherapy in minor and subsyndromal depression. A major part of this program is devoted to evaluating the clinical efficacy of various strategies for treatment-refractory depressed patients who have failed to respond to standard doses of antidepressants. Our program has also been investigating rates and treatments of depression in minority and non-minority primary care populations. Other studies concern the application of neuroimaging techniques including magnetic resonance spectroscopy and positron emission tomography to the investigation of depressive disorders. Other investigations involve genetic studies of depressive subtypes, placebo-controlled studies evaluating the effectiveness of novel antidepressant compounds. We are also studying the efficacy of various natural or "alternative" medications for depression, including St. John's Wort, SAMe and omega-3 fatty acids.
Key Words. unipolar depression, major depression, dysthymia, pharmacotherapy, cognitive therapy.
Grant Support. NIMH: (R10 MH56057-01-A2) Prediction of Outcome During Fluoxetine Continuation (MF); NIMH: Sequential Treatment Alternative to Relieve Depression (MF); NIMH: Bupropion as an Adjunct to the Nicotine Patch plus CBT (MF); Organon: A Double-Blind, Multi-Center, Randomized, Placebo-Controlled, Parallel Group Study of the Efficacy and Safety of Org33062 ER and Paroxetine in Patients with Depression and Atypical Features (MF); Pfizer Pharmaceuticals: A Double-Blind, Placebo-Controlled Study of Sildenafil for the Treatment of SSRI-Induced Sexual Dysfunction in Men (MF); Pfizer Pharmaceuticals: A Double-Blind, Placebo-Controlled Study of Sildenafil for the Treatment of SSRI-Induced Sexual Dysfunction in Women (MF); Lichtwer Pharma GmbH: A Double-Blind, Parallel Comparison of Hypericum, Fluoxetine, and Placebo in Major Depressive Disorder (JR); NIMH/NCCAM (R-01): Pharmacotherapy for Minor Depression (AN). NCCAM (K-23): Omega-3 Fatty Acids in the Treatment of Depression (DM).
Project Site. Massachusetts General Hospital, 50 Staniford Street (4th floor), Boston, MA 02114.
Program Director. Maurizio Fava, M.D., WAC 815, Massachusetts General Hospital, 15 Parkman Street, Boston, MA 02114. Tel.: (617) 724-0838.
Contact Person. Pamela Roffi, Research Coordinator. Tel.: (617) 726-8727. FAX: (617) 726-7541.
Training Opportunities. Currently, there are three fellows within the program. Two MGH-McLean Psychiatry residents are doing PGY-4 electives with our program. This program is likely to have openings in the future for other departmental trainees.
Representative Publications.
Alpert JE, Mischoulon D, Nierenberg AA, Fava M: Nutrition and depression: focus on folate. Nutrition 2000, 16:544-581.
Alpert JE, Maddocks A, Rosenbaum JF, Fava M: Childhood psychopathology retrospectively assessed among adults with early onset major depression. Journal of Affective Disorders 31:165-171, 1994.
Fava M, Rosenbaum JF, McGrath PJ, Stewart JW, Amsterdam JD, Quitkin FM: A double-blind, controlled study of lithium and tricyclic augmentation of fluoxetine in treatment resistant depression. American Journal of Psychiatry 151:1372-1374, 1994.
Nierenberg AA, McLean N, Fava M, Alpert JE, Worthington JJ, Rosenbaum JF: Early non-response to fluoxetine as a predictor of poor eight week outcome. American Journal of Psychiatry 152:1500- 1503, 1995.