NEWS & MEDIA
The most useful feature about IFMAD meetings is that current clinical hot topics and new data are presented in a balanced format, adequately dissected and discussed in a collegiate atmosphere, and digested over dinner. The meetings are always enjoyable and informative.
IFMAD in 2009 continued to be the forum where controversial subjects were discussed in a friendly collegial setting. Centre stage were presentations on the systematic delays in Europe in allowing access to new treatments. The delays in licensing followed by the bureaucracy involved in the complex and prolonged process of gaining permission to prescribe psychotropic drugs has meant that advances in treatment are being withheld from those illnesses, such as depression, which untreated have the highest levels of morbidity, disability and risk.
Filippo Drago from Italy asked why there were so few new treatments in the EU in contrast to other more open cultures and Koen Demyttenaere from Belgium detailed the concerted media attacks on the very idea that these dangerous and disabling disorders should be properly treated. The rationale of restricting access to treatment in the elderly and adolescents simply because of their age was described as unscientific and unhelpful in a careful analysis by Raimond Buller from France. Karl Broich from the German and European Medicine Evaluation Authority and Stuart Montgomery from the UK led a debate on the issue of delayed access to treatment which helped to focus the issue. The recent advances in the understanding of the nature and treatment of resistant depression were discussed in the context that there are no licensed treatments in the EU, in contrast to the USA. David Baldwin and others showed convincing new data on the rapid onset of efficacy of quetiapine and other atypicals in GAD and in resistant depression.
Excellent presentations on Posttraumatic stress disorder by Jonathan Davidson from the USA and Jose Zohar from Israel pointed to the failure and increased risk of worsening when using non pharmacological treatments. The systematic exaggeration of the benefits of psychotherapy by using inappropriate and inadequate control groups has encouraged the provision of treatments which appear to worsen the condition.
New data on the genetics of depression and resistant depression presented by Alessandro Serretti from Italy, and on ADHD by Johannes Thome from the UK helped to point to new directions for treatment. The advance in treatment of ADHD in both the young and adults was also reviewed.
Peter Hofmann from Austria drew attention to the failure to identify and treat adequately depression in diabetes and presented provocative data showing that treating the depression with the SNRI milnacipran showed benefit on both disorders. The beneficial effect of milnacipran on both pain and depression was reviewed by Siegfried Kasper from Austria.
Edward Vieta from Spain discussed the relative failure of antidepressants and to a lesser extent of mood stabilisers compared to the striking evidence of rapid and sustained efficacy with some atypical antipsychotics in the treatment of bipolar depression. Michael Bauer from Germany reviewed the evidence of efficacy in long term treatment of bipolar disorder. The need for rapid response treatments for GAD and the convincing data with pregabalin were reviewed by Jill Ramussen from the UK.
Siegfried Kasper (Austria) dissected the data on the potential differences between the response of anxiety symptoms and depressive symptoms in depression and Zoltan Rihmer (Hungary) presented data pointing to the benefit of antidepressants in reducing suicidal risk in the long term and asked whether it was rational for these treatments to carry a warning against their use. Patrice Boyer from France reviewed the treatment of anxiety and depression in schizophrenia.
The poster presentations continued the tradition of providing breaking news over the whole field of mood and anxiety disorders.
The meeting format allowed extended discussion of the issues within the meeting room and in the adjoining coffee areas and poster displays which greatly enhanced the rapid update and analysis of the advances in the understanding and treatment of these many disorders. As one delegate said: “I came to the meeting with a passing acquaintance with other delegates and left as friends. This meeting is unique”.
