N E W P H YS I C I A N S
Miriam Sevilla Saez-Benito, MD,
has joined the faculty as an assistant
professor in the Division of Child and
Adolescent Psychiatry. Sevilla received
her medical degree from the University
of Granada, Granada, Spain, and
completed her general psychiatry
residency training at Jamaica Hospital
Medical Center, Queens, New York. She
completed her child psychiatry residency
at UAB, serving as chief resident for
the 2011-2012 academic year. Sevilla
sees patients at UAB and at Children’s
of Alabama hospital emergency
department. Fluent in Spanish, she
seeks to educate parents in the Spanishspeaking community about mental illness
and to improve their access to services.
Wendell Dean Bell, MD, MBA,
has joined the UAB Department of
Psychiatry as an assistant professor
in the Consult Liaison Division. He
subspecializes in medical, surgical,
and obstetric consultations when
requested by an attending physician.
He also will assist with electroconvulsive
therapy (ECT) services and lead in the
development of a new psychosomatic
medical fellowship. Bell earned his
medical degree from the Medical
College of Wisconsin and completed his
residency at Sheppard and Enoch Pratt
Hospital in Baltimore, Maryland.
Still at Risk: Rethinking Suicide Prevention
Is it possible to disrupt a suicidal thought once
the process begins? Current psychiatric medications
target symptoms and treat underlying illnesses, but
take time to treat and have shown limited efficiency
in reducing suicidal behaviors.
Suicide is the 10th leading cause of death overall
in the US, and the fourth leading cause of death for
adults under age 65. “This suicide rate is important
when treating acutely depressed patients in the
Each year US emergency
departments see more than
a half-million admissions for
depression. UAB researchers
are studying the use of
intravenous infusions of the
drug ketamine to circumvent
depressive thoughts that lead
to suicidal behavior.
eme rgency room,” says Cheryl McCullumsmith,
MD, PhD, assistant professor of psychiatry and
president of the Alabama chapter of the American
Foundation for Suicide Prevention. “Inpatient
drug ketamine to circumvent depressive thoughts that lead to
hospitalizations are always a solution to the immediate problem
suicidal behavior. Until recently, there were few options for rapid
but typically are of short duration and may not be associated with
intervention in depression. However, studies have demonstrated
significant reduction in depression or suicidal potential. In fact,
that intravenous infusion of ketamine, an NMDA-receptor
the period of highest risk for suicide is the first two weeks post-
antagonist, at a sub-anesthetic dose (0.5 mg/kg), produced
discharge, which represents a third of all post-discharge suicides.”
antidepressant effects within hours of administration. Subsequent
Each year US emergency departments see more than a halfmillion admissions for depression. The range of outcomes includes
studies have shown benefits in treatment-resistant patients.
Of significance to the current UAB study, one small, open-label
Advancement in the Management of
Major Depressive Disorder. Ziprasidone
(Geodon) was approved by the FDA in 2001
but has not been studied in the treatment
of major depressive disorder (MDD).
The study aims to add ziprasidone to a
standard antidepressant and record the
effectiveness as an add-on medication. The
only antidepressant used in this study is
escitalopram (Lexapro). NCT00633399. PI:
Richard Shelton, MD. Contact: Samantha
White, 205.934.9189.
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attempts, making depression associated with suicidal potential
suicidal ideation in patients with depression. UAB is seeking to
a deep concern for public health. “However, presentation in the
determine whether IV ketamine infusion is safe, tolerable, and
emergency setting presents an opportunity for quick and effective
more effective than placebo in reducing both depression and
suicidal ideation in suicidal patients presenting for acute treatment
mortality, functional impact, and cost savings. There is a clear
Medication Comparison in the Treatment
of Bipolar Disorder. The comprehensive
goal of this trial is to compare lithium and
Seroquel, which is currently one of the most
prescribed drugs for the treatment of bipolar
disorder. Both drugs are FDA-approved
for the treatment of bipolar disorder,
but no study to date has compared their
effectiveness. NCT01331304. PI: Richard
Shelton, MD. Contact: Nicholas Bossaller,
205.934.2484.
test demonstrated that ketamine infusion is effective in reducing
interventions, which have a high likelihood of reducing morbidity,
F E AT U R E D
CLINICAL TRIALS
hospitalization, intensive outpatient care, and subsequent suicide
in emergency departments. The study also seeks to determine
and compelling case for the development of rapidly effective
the decreased length of stay in the emergency room and inpatient
interventions for suicidal depressed patients in the emergency
psychiatric hospital due to the rapid antidepressant effects.
department,” she says. “Professionals saw suicidal thoughts
McCullumsmith aims to use ketamine to rapidly elevate moods
as the end result of another condition, rather than as a separate
and decrease suicidal behaviors of patients who arrive to the
phenomenon, but now we are rethinking that paradigm.”
emergency department in a suicidal state. “Disrupting the cycle of
McCullumsmith and other UAB researchers are now studying
a new approach: the use of intravenous (IV) infusions of the
suicidal thoughts is the best option for the interruption of suicidal
tendencies,” she says.
continued from first page
Teenagers with schizophrenia statistically gain weight, smoke
and education plans focus on promoting family involvement and
cigarettes, isolate themselves from others, and struggle with school
emotional support, as well as providing guidance to aid in the
attendance. She says, “It is possible to break this cycle and keep
recovery process.
teenagers on a functional path.”
“There is growing evidence that schizophrenia can be managed
Belgium. She completed her internship and residency training
be lessened, if aggressive and comprehensive treatment is begun
in psychiatry at the University of Michigan and a fellowship in
shortly after the first diagnosis is made,” says Lahti.
schizophrenia research at the Maryland Psychiatric Research
monitored to keep the patient within normal functioning levels.
F OR REF ERR A L S: 1- 8 0 0 - 8 2 2- 6 47 8
Alabama Brain Collection Makes Tissue Available
The Alabama Brain Collection (ABC) is a resource of the
Department of Psychiatry. The ABC was created to promote
and encourage research with brain tissue obtained postmortem
from individuals with and without neuropsychiatric illnesses.
Its primary goal is to provide high-quality tissue, along with
comprehensive clinical information, for hypothesis-driven
research. Created in 2008, the ABC works in collaboration with
the Alabama Organ Center to expand collection opportunities.
The ABC is not structured as a brain bank, which provides open
access, but is maintained and funded through collaborative
research. The tissue collection is available to UAB scientists and
to collaborators worldwide. Rosalinda Roberts, PhD, the Kathy
Ireland Professor, is director of the ABC.
Lahti Collaborates With Auburn University
Professor Adrienne Lahti, MD, director of the Division of
Behavioral Neurobiology, has begun a collaboration with
Auburn University’s (AU) Samuel Ginn College of Engineering
and MRI Research Center. The AU center provides access to
technical research equipment to UAB and other researchers.
Auburn is expecting installation of the state’s first 7T MRI
magnet later in 2012. Lahti uses a 3T magnet for research
imaging but plans to use the larger AU magnet to measure
glutamate levels in the brains of patients with schizophrenia.
Volunteers will come from the First Episode Schizophrenia
Clinic.
Redwine Treats Depression Using rTMS Therapy
Repetitive transc ranial magnetic stimulation (rTMS) is a
non-invasive treatment that uses highly focused magnetic
pulses to stimulate function in targeted brain regions linked
to depression. This treatment is FDA-approved for patients
with major depression who have not improved on medication.
Through a treatment coil, the rTMS therapy system generates
highly concentrated magnetic fields which turn on and off very
rapidly. These magnetic fields are the same type and strength
as those produced by an MRI machine but are more focused.
No anesthesia is required, and patients are able to drive home
or return to work after their rTMS session. M. Bates Redwine,
MD, director of the Division of Geriatric Psychiatry, is medical
director of the rTMS program.
P U B L I C AT I O N S
O F N OT E
April and approved continued accreditation status for all three
programs. The General Residency and the Geriatric Fellowship
each received accreditation for five years, and the Child/
Adolescent Fellowship received accreditation for four years.
Vice Chair of Education Lee Ascherman, MD, thanked the
residents and faculty for dedicating themselves to making the
accreditation possible.
Feldman Co-Edits Handbook of Community
Psychiatry
Professor Jacqueline Feldman, MD, director of the Division of
Public Psychiatry, has co-edited the comprehensive reference
text Handbook of Community Psychiatry with Drs. Hunter
McQuistion, Wes Sowers, and Jules Ranz. The 600-page book
presents the organizational structure for community psychiatry
and reflects the rapid changes in this field, providing basic
and specialized information in areas such as epidemiology,
recovery, person-centered planning and care, innovations in
practice, and treatment of special populations. Feldman, who
is the Patrick H. Linton Professor and Vice-Chair for Clinical
Affairs, also authored several chapters of the book. Professor
Robert Savage, MD, clinical director of the Division of Public
Psychiatry, and Assistant Professor Patricia Cornett, PhD, coauthored the chapter entitled “Program Evaluation and Quality
Management.”
MEASURES OF SUCCESS
Kerman IA, Clinton SM, Simpson
DN, Bedrosian TA, Bernard
R, Akil H, Watson SJ. “Inborn
Differences in Environmental
Reactivity Predict Divergent
Diurnal Behavioral, Endocrine,
and Gene Expression Rhythms.”
Psychoneuroendocrinology, 2012
Feb;37(2):256-69.
Funk AJ, McCullumsmith RE,
Haroutunian V, Meador-Woodruff
JH. “Abnormal Activity of the
MAPK- and cAMP-Associated
Signaling Pathways in Frontal
Cortical Areas in Postmortem
Brain in Schizophrenia.”
Neuropsychopharmacology. 2012
Mar;37(4):896-905.
Clark CB, Perkins A,
McCullumsmith CB, Islam MA,
Sung J, Cropsey KL. “What
does self-identified drug of
choice tell us about individuals
under community corrections
supervision?” J Addict Med. 2012
Mar;6(1):57-67.
Inpatient Satisfaction Survey Results
Lahti received her medical degree from the University of Liege,
better, and that complications associated with schizophrenia can
She maintains that the onset of schizophrenia needs to be
UAB MEDICINE NEWS
Center in Baltimore, Maryland.
Continued Accreditation for Resident Training
Programs
The Accreditation Council for Graduate Medical Education
(ACGME) recently approved continued accreditation status
for the General Resident, Geriatric, and Child/Adolescent
Training Programs. The ACGME Residency Review Committee
examined the Specialist Site Visitor Representatives’ reports in
Inpatient satisfaction scores have risen to their highest point in two years. The improvement, says Steven Nasiatka, director
of psychiatric nursing services, can be credited in part to daily cognitive stimulation for each patient, with music, art, and
recreational therapies among techniques used to engage patients and allow them to work with the treatment staff to
understand the importance of medication compliance and learning coping skills.
MOR E INF OR M AT ION: uabmedicine.org /physician
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