Introduction
Stephen M. Stahl, MD, PhD
Adjunct Professor
Department of Psychiatry
University of California, San Diego
Chairman, Neuroscience Education Institute
Carlsbad, Calif.
Grant/Research Support: Asahi Kasei Pharma, AstraZeneca, Bristol-Myers Squibb, Cephalon, Cypress Bioscience Inc., GlaxoSmithKline, Lilly, Pfizer, Pierre Fabre and Wyeth; Consultant/Honoraria: Asahi, AstraZeneca, Avanir Pharmaceuticals, Boehringer Ingelheim GmbH, Bristol-Myers Squibb, Cephalon, Cyberonics, Cypress Bioscience, Forest Laboratories, GlaxoSmithKline, Janssen Pharmaceutica Products, L.P., Lilly, Nova Del Pharma Inc., Organon, Otsuka America Pharmaceutical, Inc., Pfizer, Pierre Fabre, Sanofi-Synthelabo Inc., Shire Pharmaceuticals Group PLC, Solvay S.A., and Wyeth. He discusses the off-label use of anticonvulsants in the treatment of schizophrenia and bipolar depression.

Mechanisms of Receptor Action
Thomas L. Schwartz, MD
Stephen M. Stahl, MD, PhD

Target Symptoms, Not Syndromes
Stephen C. Ellen, MD
Assistant Professor of Psychiatry
The University of Massachusetts Medical School
Worcester
Lecturer on topics of psychopharmacology as a member of the Speaker's Bureau at Cephalon, Inc., Elan Corporation, PLC, Eli Lilly and Company, Forest Pharmaceuticals Inc., GlaxoSmithKline, King Pharmaceuticals, Inc., Organon Inc., Pfizer Inc., Sanofi-Aventis, Takeda Pharmaceutical Company Limited, and Wyeth Pharmaceuticals. He is an active CME lecturer for organizations including CAME, CME, LLC, CommGeniX, LLC/MedXcel, LLC, Discovery Institute of Medical Education, the Neuroscience Education Institute, psychCME, and Sleep Consultant Network. He is a member of the National Physician Advisory Board for Wyeth. He has received research support from the National Institutes of Health and Organon. He is a consultant to Cephalon, Lilly, Forest Pharmaceuticals, Pfizer, Sanofi-Aventis, and Wyeth. He discusses the unlabeled use of modafinil, central nervous system psychostimulants, buproprion, atomoxetine, and atypical antipsychotics in the treatment of depression-related fatigue, sleepiness, and executive dysfunction.

Genes and Schizophrenia
Daniel R. Weinberger, MD
Director
Genes, Cognition, and Psychosis Program
Intramural Research Program
National Institute of Mental Health
National Institutes of Health
Bethesda, Md.
Nothing to disclose.

Symptoms, Circuits, and Stress
Ronnie Gorman Swift, MD
Professor and Associate Chairman
Department of Psychiatry and Behavioral Sciences
New York Medical College
Network Chief of Psychiatry
Generations +/Northern Manhattan Health Network
Chief of Psychiatry and Associate Medical Director
Metropolitan Hospital Center
New York, N.Y.
Faculty Member: Neuroscience Education Institute

This activity has been developed for clinicians and other healthcare professionals who treat individuals with bipolar, depressive, or sleep-related disorders.

The neuroscience of mental illness has been elucidated considerably during the past decade. A basic appreciation of the receptors, transmitters, and brain circuitry underlying diverse psychological processes helps the treating clinician to intervene effectively. Crucial to optimal patient outcomes is recognizing that the symptom, and not the syndrome, should be the target of intervention. By addressing dysfunction at the neuronal level, a rational basis for remedial action may become clearer. Neural circuits serving functions such as emotionality, cognition, arousal, and fatigue are reviewed with particular attention paid to the consequences of early-life stress. New concepts in the genetics of schizophrenia are highlighted with a focus on cognitive dysfunction. Successful treatment of schizophrenia and bipolar disorder addresses cognitive and affective symptoms, in addition to the more classic symptoms. By understanding mechanisms of action and receptor binding profiles of atypical antipsychotic and anticonvulsant agents, management of these important symptom domains is less puzzling.

By reading and studying this supplement, participants should be able to:

• appreciate the impact of treating symptoms rather than syndromes.

• describe the neurobiologic circuits associated with depressed mood, hyperarousal, fatigue, and distractability.

• discuss the effects of early-life stress on the hypothalamic-pituitary-adrenal axis and subsequent development of abnormal neuronal activation.

• optimize patient outcome in schizophrenia by treating three symptom domains with respect to their underlying neural circuits and transmitters.

• rationally combine antipsychotic and anticonvulsant agents, based on mechanisms of action, to treat bipolar disorder and schizophrenia.

This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the Elsevier Office of Continuing Medical Education (EOCME) and Clinical Psychiatry News. The EOCME is accredited by the ACCME to provide continuing medical education for physicians.

The EOCME designates this educational activity for a maximum of 1 AMA/PRA category 1 credit toward the American Medical Association (AMA) Physician's Recognition Award (PRA). Each physician should claim only those hours of credit that he/she actually spent in the educational activity.

Term of Approval: October 2005–October 31, 2006.

Copyright © 2005 by Elsevier Inc.