CLINICAL STUDIES OF MOOD AND ANXIETY DISORDERS
Clinical Psychopharmacology Research Program, McLean Hospital
J. Alexander Bodkin, M.D., David Brendel, M.D., Ph.D., Jacqueline Samson, Ph.D., Marion Eakin, M.D., Mary Collins, M.D., Jonathan O. Cole, M.D.
This clinical research program explores the diagnosis, symptom measurement, and treatment of depression and anxiety disorders, and the negative symptoms of schizophrenia. We have been carrying out clinical trials of a variety of potential new medications (transdermal MAO-inhibitors, tachykinin antagonists, selective benzodiazepine receptor agonists, and other novel agents) in the treatment of major depression and its subtypes (atypical and melancholic), and of generalized anxiety disorder. We have completed a series of studies of the safety and antidepressant efficacy of transdermally administered selegiline, an MAO-inhibitor with greatly reduced dietary interactions (when administered parenterally), and are engaged in the analysis and publication of this work, as well as data on the efficacy and safety of low-dose oral selegiline as an adjunctive treatment for negative symptoms in schizophrenic patients. In addition to studying the effects of new treatments, we have been engaged in studying the subjective manifestations of mood and anxiety disorders as measured by electronically-assisted experience sampling of mood and activity in anxious and depressed patients, in collaboration with Dr. Eshkol Rafaeli, at NYU. We have also begun to examine the specific manifestations of placebo effect in the patients we have studied over time in placebo-controlled trials, to attempt to replicate the findings of Quitkin et al of a characteristic placebo response pattern, and to attempt to identify other characteristics of placebo response. Finally, we are carrying out studies of posttraumatic stress disorder, comparing the rates of occurrence of PTSD symptomatology in mood and anxiety disorder patients in the presence and absence of significant trauma history. Initial findings suggest that this diagnosis may at times reflect misattribution of symptoms of depression and anxiety, rather than define a distinct clinical disorder. I am collaborating in this research with the Biological Psychiatry Laboratory, as well as in a community study of survivors of a natural disaster, to examine risk factors for developing PTSD. We also collaborate on studies concerning repressed memory and dissociation.
Findings obtained from these studies may improve our diagnostic nosology, our measurement of symptom manifestations and treatment response, and our therapeutic armamentarium in the treatment of mood and anxiety disorders, and negative symptoms of schizophrenia.
Key words: clinical trials, major depression, atypical depression, posttraumatic stress disorder, generalized anxiety disorder, negative symptoms, MAO-inhibitors, placebo effect, experience sampling methodology, parenteral antidepressants.
Program Site: Clinical Psychopharmacology Research Program, McLean Hospital.
Program Director: J. Alexander Bodkin, M.D., Clinical Psychopharmacology Research Program, McLean Hospital, 115 Mill St., Belmont, MA 02478. e-mail address: abodkin@ mclean.org
Contact Person: Tara Sorrentino, M.A., Senior Research Assistant, (617)-855-2904. Fax: (617)-855-2936
Training Opportunities: Both pre- and post-doctoral training positions may be available.
Representative Publications:
Di Tomasso C, Eshkol R, Samson JA, Bodkin JA. Mood and energy stucture and circadian rhythms in psychiatric patients (a work in progress). Presented at Society for Research in Psychopathology Meeting, Madison, November 2001.
Bodkin, JA, Amsterdam JD, Azzaro AJ, Sharoky M, Moonsammy G. Safety of transdermally delivered selegiline in a clinical setting. Presented at the American College of Neuropsychopharmacology meetings, Waikoloa, Hawaii, December 2001.
Bodkin JA, Pope HG, Hudson JI, Detke MJ, Carter WP, Cole JO. Does posttraumatic stress disorder occur only following traumatic stress? Presented at the American College of Neuropsychopharmacology meetings, Waikoloa, Hawaii, December 2001.
Bodkin JA, Kwon AE. Selegiline and Other Atypical MAO Inhibitors in Depression. Ann Psychiatry. 2001;31:(6) 385-391
Brendel DH, Bodkin JA, Hauptman B, Ornstein A. "I see dead people": Overcoming psychic numbness. Harv R Psychiatry, In press.