2. Depression
Rates Have
Tripled in the
US During
Covid-19
0.00%
5.00%
10.00%
15.00%
20.00%
25.00%
30.00%
MDD Pre-Covid MDD Sept 2020
% US population with MDD
% US population with MDD
4. Getting to
Remission:
What Happens
EachTime a
PatientTries &
Fails a
Medication
STAR*D ClinicalTrial
Funded by the
National Institute of
Mental Health
Over 4,000 patients at
41 sites
Patients underwent 4
series of
antidepressant
medications to assess
remission rates
5. Stage 1: MDD Patients
After 1 MedicationTrial
33% of patients
achieve remission
33%
67%
6. Stage 2: MDD Patients
After 2 Medications
25% of patients
achieve remission
25%
75%
7. Stage 3: MDD Patients
After 3 Medications
12% of patients achieve remission
12%
86%
8. Stage 4: MDD Patients
After 4 Medications
7% of patients achieve remission
7%
93%
9. Nearly 40% of
patients
suffering from
MDD will not
achieve
remission after 4
medication trials These patients suffer from
Treatment-Resistant
Depression
14. TheTMS Patient Experience
Course ofTreatment: 30 sessions for 20 minutes, 5 days per week
Treatment Experience: Outpatient procedure conducted in
physician’s office. Patient sits in chair while coil is placed in treatment
location and magnetic pulses delivered.
Tolerable: No systemic side effects or negative impact on cognition
Non-Invasive and Anesthesia-Free: Patients may conduct normal
activities, such as driving, work, school, etc.
24. OCD Can Be Debilitating for Patients and Families
25. Treatment-ResistantOCD
Over 2 million adults are diagnosed with OCD each year.
First line treatments include Exposure & ResponseTherapy
(ERP), CBT, and/or SSRIs.
Approximately 50% of OCD patients do not respond
adequately to first line treatments.
25
26. One of the First New
Treatments forTreatment-
Resistant OCD
27. The BrainsWay H7 coil targets the medial prefrontal and orbitofrontal
neuronal structures, including the anterior cingulate cortex (ACC).
28. Normal vs.
OCD Brain
PET scan demonstrates increase in frontal cortex regions of an
OCD vs. normal brain.
42. Intranasal ketamine spray
FDA-approved for depression
and/or depressive sx with acute
suicidal ideation/behavior
Easy to administer
Increasing insurance coverage
Effective and rapid-acting
Spravato
(esketamine)
43. Pros
Easy to administer
Effective for chronic pain
Considerations
Limited research for MDD
Typically takes 14 days to
experience relief
Only 17-25% bioavailabity
Oral
Ketamine
46. Ketamine InfusionTherapy
64% response rate, 24 hours following single IV infusion
71% response rate & 29% remission rate, 24 hours
following single IV infusion. 35% retained response after
one week.
49. Ketamine InfusionTherapy:
The Patient Experience
• Administered through an IV over a predetermined amount of time
to slowly allow for the comfort and ease of transition into a relaxed
state to enhance the cognitive effects of the treatment. Patients
must be monitored for two hours post-infusion.
• Patients cannot drive, operate machinery, or conduct activities
requiring alertness until the day after treatment session.
• Administered in six treatments over the course of two to three
weeks. Maintenance booster infusions are often needed.
50. Spravato:
The Patient Experience
Spravato is self-administered over five to ten minutes in two to
three successive intranasal sprays administered in five-minute
increments. Patients must be monitored for two hours post-
administration.
Patients cannot drive, operate machinery, or conduct activities
requiring alertness until the day after treatment session.
Weeks 1 to 4: Spravato is administered twice a week for eight doses.
Weeks 5 to 8: Once weekly.
Week 9 and after: Every 2 weeks or once weekly*
53. Who is a
Candidate for
Spravato?
Has treatment-
resistant
depression
No active
substance abuse
or psychotic
disorders
No aneurysmal
vascular disease
