Advancing Mental Health R&D for Treatment-Resistant Cases

Q: How has CISNE expanded its services to effectively respond to the growing demands in the field of mental health?

A: Since 2021, we have expanded our services to better serve our patients, establishing a state-of-the-art sleep analysis laboratory dedicated to diagnosing and effectively treating sleep disorders. Additionally, we have introduced a specialized neurology service for headaches and movement disorders, including Parkinson's disease and related conditions. In the field of neuromodulation, we have invested in advanced medical devices that enable precise modulation of specific areas of the cerebral cortex. These devices have demonstrated enhanced efficacy in treating various conditions, such as depression, anxiety, insomnia and fibromyalgia, a debilitating condition characterized by chronic pain and diminished quality of life. Moreover, we have developed specialized equipment tailored for cognitive enhancement, particularly targeting patients with Alzheimer's disease and adult attention-deficit disorder.

We have also focused on pharmacogenetics. Through strategic partnerships with three reputable companies specializing in DNA testing, we can now analyze an individual's genetic information from a small saliva sample. This groundbreaking approach allows us to determine the optimal pharmacological treatments in neuropsychiatry, tailoring medications to each patient's genetic profile and predicting their response to specific drugs.

We have broadened the range of therapeutic modalities we offer, including psychoanalytic, cognitive-behavioral, couples and sexual therapy. Additionally, we are actively exploring opportunities to extend our services into the realm of cognitive enhancement for healthy individuals. By addressing the growing demand for improved cognitive function, we aim to empower individuals seeking to optimize their mental capabilities, going beyond the traditional scope of illness-oriented treatment.

Q: What are the more prominent mental health problems and how is CISNE addressing them?

A: Depression remains a prevalent issue, with a significant increase observed during the early years of the pandemic, reaching a 50% rise. Depression is affecting 20% of the Mexican population, compared to the pre-pandemic figure of 9.1%. Anxiety has emerged as the most prevalent disorder. Pre-pandemic figures put its prevalence at 14.5% but recent studies indicate that over 40% of the population now experiences anxiety disorders. These findings encompass a wide range of conditions, including post-traumatic stress resulting from the collective experiences surrounding the pandemic. 

To respond to the challenges caused by the pandemic, we expanded our team to include three child psychiatrists. We are witnessing a surge in intellectual developmental disruptions among children. To address this, we have established a specialized cognitive rehabilitation program for children who are experiencing a delay of up to two years in acquiring essential knowledge and mathematical reasoning skills. Many children have experienced academic difficulties and delayed intellectual development due to the transition to online learning. Not all academic challenges are indicative of attention-deficit disorders. 

Q: What new products is CISNE developing and how will they benefit patients? 

A: Alongside our partners, we are researching Alzheimer's vaccines and intranasal antidepressant enhancers that complement depression treatment and provide an 82% improvement in treatment-resistant depression. These approaches are breaking paradigms as they offer treatment pathways beyond the conventional biochemical approaches. In November, we will launch a neuro corticosteroid to treat depression, which has shown significant improvements within three days. Its effectiveness is comparable to a year-long antidepressant treatment.

Q: What are the main advantages of the Alzheimer’s vaccine you are studying?

A: Two Alzheimer’s vaccines have received approval from the US Food and Drug Administration (FDA). We have a research protocol for one of those vaccines and the other has not arrived in Mexico. These vaccines are developed for preclinical Alzheimer's patients, those who are at risk of developing Alzheimer's disease but who have not developed it yet. The search for candidates has been difficult. We are focusing on individuals who have first-degree relatives with Alzheimer's and we request a sample of cerebrospinal fluid obtained through a small puncture in the back, which is analyzed to measure the levels of beta-amyloid protein. These vaccines are designed to target antibodies against beta-amyloid protein. If someone already has Alzheimer's, the vaccines will not be effective and may even cause brain inflammation.

Q: What strategies are needed for these treatments to become more accessible to the general population?

A: Medical education surged during the pandemic. The accessibility of information and the confinement measures made health-related issues some of the top internet searches. The decrease in stigma surrounding mental health and the flexibility in psychoeducation allowed us to gain a 10-year advantage. However, access remains challenging. 

Several technologies are primarily designed for treatment-resistant cases. But as people become more aware of their condition, we will see improved accessibility because we have faster and more objective diagnostic procedures. As the use of these new treatments becomes more widespread, we can expect prices to decrease over time. All that is required is patience and maintaining the current pace of progress.

Q: How effective have teleconsultations been in addressing mental health issues? 

A: Teleconsultations have become normalized. During the pandemic, psychiatry converted 47% of appointments to teleconsultations. Between 10% and 15% of all our activities are now conducted online. Many neuropsychological tests have also transitioned to an online format, which has facilitated the growth of CISNE and expanded our reach beyond Mexico City. About 10% of our patients are from other regions in Mexico or even from abroad, predominantly Latin American individuals residing in the US. Access to mental health services is challenging and expensive in their place of residence. In late 2021, we successfully implemented an interconnected electronic medical record system across all departments, enabling us to carry out teleconsultations with greater ease and confidence.

Q: What specific measures does CISNE take to ensure patient privacy and confidentiality of information in the digital era?

A: Everything is standardized. We were part of a working group for the Mexican Senate that successfully advocated for the establishment of secondary laws that empower teleconsultations. While teleconsultations were not explicitly prohibited by the General Health Law, the secondary laws had not been implemented. The newly established laws now mandate the signing of a consent form for teleconsultations and the private handling of information. Teleconsultations are now legally equivalent to in-person medical consultations. As the data involved is personal, electronic medical records must adhere to strict security protocols, as outlined in the official regulations for electronic records. There has also been a shift toward multiplatform accessibility and, for example, we use the same platform for teleconsultations as we do for managing electronic medical records.

Q: How is CISNE actively fostering partnerships and collaborations with other healthcare providers, mental health organizations or academic institutions?

A: Our priority is to establish a partnership with a neurological rehabilitation company, initially focusing on children and later expanding to other patients. The significant surge in child psychiatry necessitates this collaboration. We are also on the verge of finalizing an agreement with a video platform. There has been growing interest in mental health but most videos are created by individuals lacking academic expertise. These viral methodologies are often unscientific. The video platform approached us to create ethical and scientifically accurate materials for the proper dissemination of mental health information and treatment approaches.

Q: What are your current priorities ?

A: We aim to standardize our processes to open additional branches in other parts of the country. Furthermore, we strive to continue developing new technologies for treatment-resistant cases. There are technologies that are past the research stage but are not available in Mexico due to regulatory processes. We want to be a driving force that demands and encourages the pharmaceutical and medical device industry to pursue licenses and agreements that bring these tools to Mexico. Another area in which we have been experiencing significant growth is in fostering partnerships and facilitating access to new technologies.

Our goal is for the brand of CISNE México to be associated with the benefits of seeking mental healthcare. The next step is for patients to actively seek out our brand above any specific specialist.