Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean of the Icahn School of Medicine at Mount Sinai and President for Academic Affairs of the Mount Sinai Health System has consistently been at the forefront of treatment discoveries for mood and anxiety disorders. He pioneered ground­-breaking therapies for treatment-resistant depression, including ketamine. Dr. Charney is now poised to revolutionize the field again with Emotional Faces Memory Task (EFMT) technology.

EFMT is a cognitive-emotional treatment delivered via software. The seeds of this idea were developed more than 20 years ago while Dr. Charney was studying prisoners of war from Vietnam. "Many of them were held in solitary confinement, where they weren't allowed to talk, and all they could do was think," Dr. Charney recalls. ''When I interviewed them. I discovered that they'd developed cognitive capacities they'd never had before. One taught himself enhanced math, while another wrote books, and a third built houses- all in their minds. It made me realize that we could change brain circuits, so people could develop capacities they'd never had before."

Dr. Charney collaborated with one of his postdoctoral fellows at the time, Brian Iacoviello. PhD. now an Adjunct Assistant Professor of Psychiatry at Icahn Mount Sinai, to design and then test a task that could potentially change the brain circuits of patients struggling with depression.

The result was EFMT. "You do the exercise, and it interacts with the frontal part of the brain, known as the frontal cortex, as well as an emotional center of the brain, the amygdala." explains Dr. Charney.

Individuals with major depressive disorder tend to have increased neural activity in their amygdala and decreased activity in their prefrontal cortex. But the tasks in the software- which include identifying emotions displayed on a series of faces- are designed to activate and strengthen balance in both brain regions. 'They target some of the thinking abnormalities we see among patients with depression, such as negative thoughts and ruminating," says Dr. Charney.

A 2018 study published in the journal Nature Digital Medicine found that patients with depression who used the software for 18 sessions over six weeks had a significantly greater improvement in symptoms than a control group. More than a third of participants also achieved clinical response­ meaning more than a  so  percent  reduction in symptoms-  compared to  just 17  percent of the  control group. "It's comparable to what we'd see if they were on antidepressant medication", notes Dr. Charney.

Building on this success. Icahn  Mount  Sinai has licensed EFMT to Click Therapeutics™, which is collaborating with Otsuka America, Inc., to further develop and commercialize this technology. "Ideally, EFMT could be used by patients for whom traditional treatments, like antidepressant medication, are not sufficient or do not address the underlying cause of their disease," says Dr. Charney. "It's another potential tool in our arsenal."

First FDA-Approved Digital Therapy for Major Depressive Syndrome

U.S. Food and Drug Administration (FDA) has cleared Rejoyn™ (developed as CT-152), the first prescription digital therapeutic authorized for the treatment of major depressive disorder (MDD) symptoms as an adjunct to clinician-managed outpatient care for adult patients with MDD who are on antidepressant medication. Rejoyn™ is intended to reduce MDD symptoms. Dr. Charney and one of his post-doctoral fellows, Brian Iacoviello, PhD, co-created the 'Emotional Faces Memory Task' or EFMT which was later licensed to Click Therapeutics and sublicensed to Otsuka who completed the first clinical trials of Rejoyn™.