Dr. Stefan Kloiber uses an Academic Scholar Award and the Labatt Family Grant to investigate Mood disorder Integrated Care Pathways (ICPs) and the Endocannabinoid System in Social Anxiety Disorder

Dr. Stefan KlobierAssistant Professor Dr. Stefan Kloiber recently received an Academic Scholar Award and the Labatt Family Grant from the Department of Psychiatry at the University of Toronto. As a Psychiatrist and Clinician Scientist in the Mood and Anxiety Division and Campbell Family Mental Health Research Institute at the Centre for Addiction and Mental Health (CAMH), he is using these funds to support two innovative studies.

Academic Scholar Award: Mood disorder Integrated Care Pathways (ICPs)

Major Depressive Disorder (MDD) is one of the most prevalent and debilitating psychiatric disorders worldwide. Conventional treatment approaches, such as antidepressants and psychotherapy, fail in a large number of patients and up to 35% are confronted with treatment resistant depression (TRD).

Dr. Kloiber and his team have developed an evidence-based structured treatment program, the Integrated Care Pathway (ICP) for MDD in addition to the ICP for Bipolar Disorder at CAMH. He anticipates that these ICPs will improve access to sufficient state-of the art care and will eventually improve treatment outcomes and prevention of TRD. The project will additionally support continuity and coordination of care in collaboration with primary care settings, and provide well-defined standards of care that will set the bar for future performance measurement.

At the same time the structured and measurement-based nature of these ICPs, as well as the large patient population, will provide an optimal platform for integrating clinical research to evaluate different treatment interventions. They will establish a large clinical database and biobank for investigation of clinical and biological indicators to further refine and guide treatment decisions in mood disorders.

Labatt Family Grant: Cannabidiol, Endocannabinoid System, and Social Anxiety Disorder

Social Anxiety Disorder (SAD) occurs early in life and affects about 2.5 million Canadians per year. In addition, more than one third of SAD patients do not benefit from available pharmacotherapy approaches or psychotherapy.

Poor signaling of the endocannabinoid anandamide (AEA), a key neurotransmitter of the brain endocannabinoid system (ECS), through up-regulated metabolic activity of Fatty acid amide hydrolase (FAAH) has been suggested to be a neurobiological mechanism contributing to anxiety and impairment in social functioning. In this research project, Dr. Kloiber and co-investigators will evaluate the activity of the ECS by directly measuring FAAH through brain PET (Positron emission tomography) imaging of individuals with SAD using the newly developed marker [11C]CURB, which will provide valuable information on neurobiological mechanisms in SAD and inform development of potential future treatments.

In addition, Cannabis products are increasingly used to relieve anxiety despite uncertainty about risks and benefits. Cannabidiol (CBD), a phyto-cannabinoid lacking the unwanted psychotropic effects of Tetrahydrocannabinol (THC), has been reported to have potential therapeutic effects on anxiety and to be well tolerated. In collaboration with an industrial partner, Dr. Kloiber and colleagues are planning to evaluate potential effects of a cannabis product with high CBD content as innovative treatment for SAD in a placebo-controlled study.

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