This panel will discuss novel interventions for treatment resistant conditions.
Dr. Ziv Cohen will review how to identify patients with treatment-resistant depression who may benefit from interventional psychiatric treatments, including transcranial magnetic stimulation (TMS), ketamine, and electroconvulsive therapy (ECT). Participants will learn practical criteria for recognizing treatment resistance, assessing clinical severity, and determining when referral for interventional evaluation is appropriate. The session will also discuss the indications, patient selection considerations, and comparative roles of TMS, ketamine, and ECT within evidence-based treatment algorithms for depression.
Dr. James Murrough will review the clinical burden of major depressive disorder and treatment-resistant depression, highlighting the limitations of conventional monoaminergic antidepressants that spurred the search for rapid-acting alternatives. The talk will trace the discovery and mechanism of ketamine and esketamine, including pharmacology and clinical efficacy and safety, in treatment- resistant depression and depression with suicidal ideation. The talk then turns to classic psychedelics, such as psilocybin, examining their proposed 5-HT2A receptor-mediated mechanisms of neuroplasticity and how the emerging mechanistic and clinical evidence compares and contrasts to that for ketamine.
Drawing on the Montreal Model of ketamine-assisted psychotherapy, whose motto is "feel your feelings, defuse your thoughts, change your behaviors," Dr. Joseph Diehl will describe how clinicians can use familiar CBT tools before, between, and after dosing sessions, and which patients may be the best fit. He will also discuss conditions beyond depression, including OCD, anxiety, and substance use, and what the current evidence does and does not yet support.
The panel will be moderated by Dr. Sharon M. Batista, a board-certified psychiatrist, Assistant Clinical Professor of Psychiatry at Mount Sinai, and Distinguished Fellow of the American Psychiatric Association. With over 15 years of clinical experience, Dr. Batista brings expertise in complex psychiatric conditions and a collaborative approach to treatment, including experience referring patients with treatment-resistant depression for interventional care. Her clinical and academic perspectives will help contextualize the panelists’ discussions within the broader landscape of evidence-based psychiatric practice.