History of the Mood Clinic:
The Moodclinic program began in 1984 with the Psychopharmacology Research and WHO programs under Dr. Bishon Saxena and Dr. Duncan McCrimmon at McMaster University Department of Psychiatry, and became affiliated with psychiatric clinics in Burlington, Oakville, North Halton and Mississauga. It formally became the Moodclinic program in the year 1998 to help further research and novel treatments for clients with serious psychiatric disorders including severe depression, anxiety, bipolar disorders and schizophrenia.
In 2000 after the death of Dr. Bishon Saxena, the program was taken over by Dr. Peter G Turner and Dr. Satpal Girgla . Offices were last at 301-720 Guelph Line, Burlington, and in 2018 moved to the Joseph Brant Community Mental Health Program, 1182 North Shore Boulevard, Burlington.
The Mood Clinic program participated in about 75 Research projects, including several pivotal drug trials, starting in 1984 at the Joseph Brant Hospital and then our research clinic, from 2000 to 2017. Currently we are continuing to look at potential projects involving novel medical and complimentary treatments for severe psychiatric disorders.
Information about the Importance of Clinical Trials:
Since the 1950s, there has been a rapid increase in bio-pharmaceutical research, which has improved the quality of life for many individuals living with a mental disorder. However further therapeutic advances are needed for people not helped by current treatments or those who experience negative side effects. Further research into new or improved treatments is dependent on developing a better understanding of how current treatments work, identifying biomarkers useful in making diagnosis and responses to therapies, and finding new therapeutic targets through identification of the abnormal factors contributing to mental disorders. NIMH reports provide a useful overview of the recent state of pharmaceutical research. 1. NIMH Brief 2014 Mental Health Medicines in Development, and NIMH Report 2014 Mental Health Medicines in Development.
Clinical Trials Examples:
A. Treatment of Major Depression remains challenging due to approximately 50% partial and non-response to standard antidepressant therapies. Especially Cognitive symptoms, difficulty concentrating, planning, decision making and forgetfulness) are very prevalent and have a direct impact at the workplace
The AtWORC Study was a multicenter antidepressant switch trial with Vortioxetine, (Brintellix), a new multimodal antidepressant, that helps to improve mood and cognitive functions, particulary at work. 1. Lundbeck Brintellex Brief, 2. McIntyre et.al Vortioxetine in cognitive function in MDD 2014. 3. AtWoRC Study results 2018 Paper 4. AtWoRC Study results 2017 Poster
The ARGO Study was a multicenter augmentation (add-on) trial for Treatment Resistant Depression with Brexpiprazole (Rexulti), an atypical anti-psychotic mood stabilizer that was shown to be very helpful in a significant number of clients and was approved in the US in 2015 and Canada 2019. 1. Lundbeck Brexpiprazole Brief , 2. Health Canada Approves Brexpiprazole (Rexulti) as Adjunctive Treatment of MDD, 3. Brexpiprazole Augmentation in TRD – Sage, 4. Brexpiprazole as an augmentation agent to antidepressants in treatment resistant major depressive disorder. – PubMed – NCBI,
B. The Treatment of Negative Symptoms in Schizophrenia is challenging with poor treatment response, which are a key factor determining long-term disability associated with this disorder. Effective treatments for these symptoms are lacking. Deficient signaling through the N-methyl-D-aspartate (NMDA) receptor may underlie many signs and symptoms of schizophrenia, in particular negative symptoms. Targeting the modulatory glycine site of the NMDA receptor by reuptake inhibition of glycine offers a safe approach to enhance deficient NMDA receptor functioning.
Bitopertin, a NMDA receptor enhancer, after initial phase-2 trials, gave disappointing results in two phase-3 to treat negative symptoms. We also did see some positive subjective comments by clients, but these did not play out in the data analysis. 1. GlyT-1 Receptors and Schizophrenia Summary 2. Umbricht ICOSR poster 3. 2014.06 JAMA Psychiatry Phase-2 Trial Bitopertin, CandleLyte Study 4. 2014.04 APA Phase-3 Bitopertin Results