Spotlight On: Professor Malcolm Hopwood
Mood disorders like Major Depression represent one of the leading causes of disability globally. Current treatment is frequently limited in its effectiveness and sourcing the most effective treatment complicated by our limited ability to personalise treatment.
Professor Mal Hopwood, from the University of Melbourne, Department of Psychiatry at Ramsay Clinic Albert Road is leading a series of studies investigating new treatment options for Major Depression and strategies to improve the personalisation of their use.
The translational research team at Ramsay Clinic Albert Road has been developed in association with the Ramsay Clinical Trial Network and the strong support of the Ramsay Hospital Research Foundation. At Albert Road, the team has participated in multicentre trials evaluating the impact of esketamine on quality of life, intranasal esketamine versus racemic ketamine given subcutaneously and trials of new oral versions of ketamine. In a translational sense, this has also led to the development of a Ketamine Clinic at Ramsay Clinic Albert Road and a significant contribution to the introduction of esketamine to the Pharmaceutical Benefits Scheme in Australia.
The Albert Road team has also participated in several controlled studies of psychedelic assisted psychotherapy in both Major Depression and PTSD. Participation in these trials offers an interesting opportunity to observe the realities of these much-discussed interventions, including the translational challenge of therapies requiring intense time-laden input from multiple therapists. Added to the significant cost burden for non-trial based psychedelic therapy, this represents a significant challenge in translation to clinical practice in the future.
With support from the Ramsay Hospital Research Foundation, the Ramsay Clinic team has recently completed recruitment for a major randomised control trial evaluating pharmacogenomic guided prescribing in acute inpatient care for mood disorders. Although full results are still not yet available, at an experiential level the study has demonstrated translational challenges around timing of testing and availability of results, together with their interpretation. Clinical decision making as to new pharmacotherapy is often required within 24 hours of admission, whereas pharmacogenomic results may take several days to become available. This leads to further consideration of where the ultimate role of pharmacogenetic testing in mental health may best be placed.
The team at Albert Road are now focused on the development of further clinical trials in collaboration with the Ramsay Network, other researchers within the University of Melbourne and elsewhere.