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FALL 2014

Chairman's Message

 
Mark Hyman Rapaport, MD

I hope everyone had a rejuvenating summer! Our Department will continue its extraordinary metamorphosis this Fall. The Fuqua Center, all of our education programs, the geriatric division, and the majority of outpatient components of the Department of Neurology will join our child division and outpatient clinical and clinical research programs in newly renovated space in Executive Park 12 as Phase IB of Emory’s Brain Health Initiative. In this edition of BrainWaves, we feature some faculty members (Leonard Howell PhD, Adriana Hermida MD and Martha Ward MD) who have truly developed leading edge programs in drug development, Parkinson’s disease and treatment programs to care for the psychiatric and medical needs of complex patients. We also feature our newly renovated state-of-the-art inpatient programs for adult and geriatric psychiatry patients. These are groundbreaking times for our Department and there is more to come!


Kicking cocaine addiction

 
Leonard Howell

Cocaine use is epidemic in this country. Up to 10 percent of people who try cocaine become addicted to it.

Neuroscientist Leonard Howell hopes to loosen the grip of addiction. Using sophisticated PET and fMRI imaging at Yerkes National Primate Research Center, Dr. Howell has found that initial cocaine use in rhesus monkeys that were previously drug naïve activated an area of the brain within the prefrontal cortex that is part of the reward pathway. However, when the monkeys used cocaine for an extended period of time, to model compulsive drug use in humans, the areas of the brain that were affected spread markedly to include regions responsible for compulsive behavior, cognition and emotion.

“Traditionally, drug addiction research has focused on these brain reward pathways that involve dopamine transmission,” says Howell, who was recently appointed associate director for Scientific Programs at Yerkes. “However, with chronic drug use, the cortical systems that involve serotonin transmission become very important.”

Howell and his team have identified a specific serotonin receptor – the 2A receptor – that becomes hyperactive with cocaine use. He was then able to administer a drug that blocks that particular receptor, and the monkeys became resistant to relapse.

“We allowed monkeys to self administer cocaine for some extended period of time, followed by long-term abstinence from cocaine use,” he says. “If we then gave them another dose of cocaine, they would go back to their drug-taking behavior. However, if we give the monkeys this receptor blocker, they don’t start using cocaine again even after getting the cocaine. It completely blocked a relapse.”

Howell believes his findings hold great promise for treatment of cocaine addiction. “We are very excited about this,” he says. “The cortical mechanisms in primates are very similar to those in humans, so the fact that this drug works so well in monkeys is very promising.”


Newly designed inpatient services at Emory University Hospital at Wesley Woods

 

In March of 2014, Emory University Hospital at Wesley Woods initiated a new adult and geriatric inpatient psychiatry program. This academic program utilizes best practices for the treatment of psychiatric disorders including treatment-resistant anxiety and mood disorders. Inpatient care includes diagnostic assessment, initial treatment, and crisis stabilization to facilitate safe patient transitions from inpatient to outpatient settings. Advanced treatments for psychiatric and mood disorders such as Electroconvulsive Therapy (ECT), Ketamine infusions and Transcranial Magnetic Stimulation (TMS) are offered.

The program is conducted in two newly renovated, state of the art secured environments. Treatment modalities include: expert psychiatric evaluation and treatment, skillful nursing assessment and care, interdisciplinary and psychotherapeutic approaches, comprehensive discharge planning, family education, and stabilization of substance dependence as a secondary diagnosis. A commitment to patient and family centered care remains our focus and guidepost in providing these comprehensive services. Additionally, timely communication with referral sources during inpatient stays and at the time of discharge is provided.

The therapeutic milieu consists of a variety of individual sessions, groups, and topics. Group and individual activities include those related to goal setting, age-specific needs, coping skills, grief and loss, relapse prevention, spirituality, family issues, and medication education. These therapeutic encounters are provided by an Emory Department of Psychiatry interdisciplinary team of attending physicians, fellows, residents, medical students, nationally certified nurses, licensed clinical social workers, licensed marital and family therapists, and certified addiction counselors.

Senior leaders of the program include: Dr. Robert Cohen, Chief of Service In-patient Psychiatry; Jennifer Schuck, EWWH Associate Administrator; and Annette Branan, EWWH Chief Nursing Officer.

Program referrals may be made through our Behavioral Health Clinical Evaluators at 404-728-6222. Patient clinical information, demographics, and insurance information will be needed to complete the admission referral. Prospective patients who have an acute, unstable medical condition(s) or significant cognitive impairment may not meet the criteria for active patient participation in our treatment program. Insurance will be verified by our Behavioral Health Clinical Evaluators prior to admission.

     
 
 

Jennifer Holton joined the department in July as the Program Director for the Child and Adolescent Psychiatry Fellowship. She is a native of Georgia and a graduate of Emory College. She was previously the Assistant Program Director for Duke’s Child and Adolescent Psychiatry Fellowship program.


Offices of the Psychiatry Education suite are moving from Tufts House to the 3rd floor of Executive Park 12 by the end of September. All residency recruitment interviews will take place at Executive Park beginning on October 24 and continuing into January. This new space will provide us with updated and increased space for residency training activities.


   
 

Dr. Barbara Rothbaum and her team of researchers and clinicians examine how Virtual Reality can treat Veterans’ PTSD. Read more...


 

Dr. Nadine Kaslow, who is a world renown authority on suicide, was quoted in many places in the media after the tragic suicide of Robin Williams. To view a few of these articles read more:


 

This section will highlight different aspects of the Department of Psychiatry and Behavioral Sciences that people may not be aware of.


Emory’s Movement Disorder division created the Parkinson Disease Comprehensive Care Center in order to bring multi-disciplinary expertise together to provide efficient and comprehensive care to patients and caregivers. Dr. Adriana Hermida, a geriatric psychiatrist with a special interest in neuropsychiatric disorders who has been an active partner in the Comprehensive Care Clinic from the start, provides each participant with a complete psychiatric evaluation and assessment. She states “usually people with Parkinson’s Disease would not see a psychiatrist as they don’t think they have a psychiatric problem. However, a majority of the patients I see have symptoms of depression, anxiety or impulse control disorder which have the potential of becoming even more debilitating then their motor symptoms. Treatment can make a big difference in their quality of life.”

This clinic is a collaborative effort between Psychiatry and Neurology. To refer to this clinic please call: (404) 728-4982 or email pclinic@emory.edu


The Park Place Collaborative Care clinic was developed by Dr Martha Ward after the completion of her combined residency in Internal Medicine and Psychiatry in 2012, with funding provided by the Fitzgerald Foundation. The clinic is located in Grady's outpatient behavioral health center, and serves the complex medical and psychiatric needs of patients with severe and persistent mental illness who previously did not receive any continuity of medical care. The clinic also serves as an excellent educational opportunity for trainees from various disciplines, including Emory medical and PA students, psychiatry and internal medicine residents, and psychology interns.


Emory has a number of new clinical studies that are actively recruiting people seeking treatment as well as control participants. If you are interested in learning more, please click here.


 

Your support will help us to partner together for Atlanta and Beyond. To make a gift to the Department of Psychiatry please click here.

 
 
If you have any comments or suggestions please contact Phyllis Rosen LCSW at prosen@emory.edu