Day 2 :
National Institute of Public Cooperation and Child Development, India
Keynote: Myocardial infraction and depression in patients admitted at All India Institute of Medical Science and Satya Sai Institute of Higher Medicine
Time : 09:15-10:00
Soumen Acharya is working as Consultant at National Institute of Public Cooperation and Child Development New Delhi, India. Previously, he worked as Supervising Officer at All India Institute of Medical Science for 21 years’ and also worked in New Zealand. He published so many papers in a leading journal. He is the Life Member of organizations like: Social Psychiatry in India and Fellow of Social Psychiatry of India.
The total numbers of patients taken up were 100 who were admitted with MI. To find out the prevalence of depression we used dsm-1v criteria 26 patients were found to have major depressive disorder. Among them 10 were severe, 13 were moderate and three were mild according to HDRS score. Another 26 patients showed evidence of depressive symptoms which may be due to extreme subjective distress. There was no significant difference of demographic variables between patients with major depressive disorder. Mean frequency of life events was significantly higher in major depressive disorder group. Except type a behavior, depression was not associated with duration, types, risk factors, treatments and complications of myocardial infraction. Past and family histories of depression were identified as risk factors for major depressive disorder after infraction. The patients with myocardial infraction, sub-syndromal depression is suggestive of self-limited reaction while treatment of major depressive disorder may reduce overall distress of the patients. The type of result which was observed in AIIMS and SSIHM were found to have no difference at all.
Stony Brook University, USA
Time : 10:00-10:45
Sudhir Gadh is a Board-Certified Psychiatrist. He is specialized in treating patients with ADD, anxiety, and trauma. He is interested in working with patients who want to uncover their own obstacles, recover from pain and suffering, and are motivated to thrive. He serves as Commander in the Naval Reserves. He is certified by the American Board of Psychiatry and Neurology and is a Member of the American Psychiatric Association. He holds an Undergraduate degree from New York University and a Medical degree from St. George's University. He has completed his Residency training at SUNY Stony Brook and a Fellowship in Public Psychiatry at NYU/Bellevue.
Despite advances in pharmacology, diagnosis and treatment of psychiatric conditions, suicide and homicide remain not only prevalent but are rising in certain parts of the United States. While economic and substance abuse factors are significant, I’d like to show how failures in prescribing practices are contributing, specifically in the under-prescribing of the most effective anti-suicidal medication/mineral: Lithium. Using data from 2013, showing the top 25 most prescribed psychiatric medications, it is clear that lithium is both misunderstood and ignored as a weapon against mental illness. The reasons for this begin with the influence of pharmaceutical companies and end with the fear and ignorance of how effective even small doses of lithium can be. I will share both data from around the world, anecdotal data from my years of practice and stories from both to illustrate why low dose lithium use is not only safe and effective in a variety of conditions but potentially game changing on a global scale.
University of Notre Dame Australia, Australia
Keynote: Kynurenine aminotransferases and the prospects of inhibitors for the treatment of Schizophrenia
Time : 11:00-11:45
Richard Sadig has completed an honours degree in Pharmacy from the University of Sydney focusing on drug inhibitors for the treatment of schizophrenia. He came first in his cohort for Drug Discovery and Design and received the Dean's award for Academic Excellence. Since then he has completed a Postdoctorate degree in Medicine and Surgery at the University of Notre Dame, Sydney. He was recently appointed as Security and Advisory Committee Member for the medico-legal indemnity company AVANT in 2017 and is currently working as a Clinical Doctor in St. George Public Hospital. His goal is to one day procure a molecule that can manage the negative symptoms of schizophrenia which contributes to the overall morbidity of the patient. His position in both the Pharmacy sector and the Medicine field has helped him significantly in these goals.
Schizophrenia is a complex neuropsychiatric disorder with limited treatment options and highly debilitating symptoms, leading to poor personal, social, and occupational outcomes for an afflicted individual. Our current understanding of schizophrenia suggests that dopaminergic and glutamatergic systems have a significant role in the pathogenesis of the disease. Kynurenic acid, an endogenous glutamate antagonist, is found in elevated concentrations in the prefrontal cortex and cerebrospinal fluid of patients with schizophrenia, and this affects neurotransmitter release in a similar manner to previously observed psychotomimetic agents, such as phencyclidine, underlining the molecular basis to its link in schizophrenia pathophysiology. Kynurenic acid is a breakdown product of tryptophan degradation, through a transamination process mediated by kynurenine aminotransferase (KAT) enzymes. There are four KAT homologues reported, all of which are pyridoxal 5’- phosphate-dependent enzymes. All four KAT isoforms have been analysed structurally and biochemically, however the most extensive research is on KAT-I and KAT-II. These two enzymes have been targeted in structure-based drug design as a means of normalising raised kynurenic acid levels. The most potent KAT-I inhibitors and KAT-II inhibitors include phenylhydrazone hexanoic acid derivatives and a pyrazole series of compounds, respectively. KAT inhibitors have been shown to be effective in reducing kynurenic acid production, with accompanying changes in neurotransmitter release and pro-cognitive effects seen in animal studies. This review will discuss the characteristics pertaining to the different KAT isoforms, and will highlight the development of significant KAT inhibitors. KAT inhibitors have great potential for therapeutic application and represent a novel way in treating schizophrenia.