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Semin Neurol 2009; 29(3): 200-219
DOI: 10.1055/s-0029-1223877
© Thieme Medical Publishers

Psychopharmacology for Neurologists

Steven L. Dubovsky1 , 2 , 3 , Amelia N. Dubovsky4
  • 1Department of Psychiatry, University at Buffalo, Buffalo, New York
  • 2Department of Psychiatry, University of Colorado, Denver, Colorado
  • 3Department of Medicine, University of Colorado, Denver, Colorado
  • 4Department of Psychiatry, Harvard University, Cambridge, Massachusetts
Further Information

Publication History

Publication Date:
23 June 2009 (online)

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ABSTRACT

Psychiatric disorders are common in neurological patients, and psychopharmacological agents are frequently used to treat agitation and other problems in neurological practice. Antidepressants are effective for depression caused by neurological illness, but they can interact with other medications. Antianxiety drugs can aggravate cognitive disorders and should be used cautiously in this context. Antipsychotic drugs can be useful for acute agitation, but they are being found to be neither effective nor safe for chronic nonpsychotic agitation. Other agents such as β blockers and serotonergic agents are being found to be more useful. Uses, doses, adverse effects, and interactions of psychiatric medications in neurology are summarized in this article, and suggestions are provided for the practical application of these treatments.

KEYWORDS

Psychopharmacology - medication - psychiatric - adverse effects - agitation - antidepressant - antipsychotic - anxiolytic

REFERENCES

  • 1 Schildkraut J J, Schanberg S M, Breese G R, Kopin I J. Norepinephrine metabolism and drugs used in the affective disorders: a possible mechanism of action.  Am J Psychiatry. 1967;  124(5) 600-608
    PubMedGoogle Scholar
  • 2 Gold P W, Licinio J, Wong M L, Chrousos G P. Corticotropin releasing hormone in the pathophysiology of melancholic and atypical depression and the mechanisms of action of antidepressant drugs.  Ann N Y Acad Sci. 1995;  771 716-729
    CrossrefPubMedGoogle Scholar
  • 3 Shelton R C. Intracellular mechanisms of antidepressant drug action.  Harv Rev Psychiatry. 2000;  8(4) 161-174
    PubMedGoogle Scholar
  • 4 Tardito D, Perez J, Tiraboschi E, Musazzi L, Racagni G, Popoli M. Signaling pathways regulating gene expression, neuroplasticity, and neurotrophic mechanisms in the action of antidepressants: a critical overview.  Pharmacol Rev. 2006;  58(1) 115-134
    CrossrefPubMedGoogle Scholar
  • 5 Caley C F. Extrapyramidal reactions and the selective serotonin-reuptake inhibitors.  Ann Pharmacother. 1997;  31(12) 1481-1489
    PubMedGoogle Scholar
  • 6 Dubovsky S L. Beyond the serotonin reuptake inhibitors: rationales for the development of new serotonergic agents.  J Clin Psychiatry. 1994;  55(Suppl) 34-44
    PubMedGoogle Scholar
  • 7 Gerber P E, Lynd L D. Selective serotonin-reuptake inhibitor-induced movement disorders.  Ann Pharmacother. 1998;  32(6) 692-698
    CrossrefPubMedGoogle Scholar
  • 8 Gill H S, DeVane C L, Risch S C. Extrapyramidal symptoms associated with cyclic antidepressant treatment: a review of the literature and consolidating hypotheses.  J Clin Psychopharmacol. 1997;  17(5) 377-389
    CrossrefPubMedGoogle Scholar
  • 9 Dubovsky S L, Thomas M. Tardive dyskinesia associated with fluoxetine.  Psychiatr Serv. 1996;  47(9) 991-993
    PubMedGoogle Scholar
  • 10 Movig K L, Leufkens H G, Lenderink A W et al.. Association between antidepressant drug use and hyponatraemia: a case-control study.  Br J Clin Pharmacol. 2002;  53(4) 363-369
    CrossrefPubMedGoogle Scholar
  • 11 Dubovsky S L. Clinical Guide to Psychotropic Medications. New York, NY; WW Norton 2005
    Google Scholar
  • 12 Mukherjee S, Sackeim H A, Schnur D B. Electroconvulsive therapy of acute manic episodes: a review of 50 years' experience.  Am J Psychiatry. 1994;  151(2) 169-176
    PubMedGoogle Scholar
  • 13 Devanand D P, Dwork A J, Hutchinson E R, Bolwig T G, Sackeim H A. Does ECT alter brain structure?.  Am J Psychiatry. 1994;  151(7) 957-970
    CrossrefPubMedGoogle Scholar
  • 14 Gwinn R P, Kondratyev A, Gale K. Time-dependent increase in basic fibroblast growth factor protein in limbic regions following electroshock seizures.  Neuroscience. 2002;  114(2) 403-409
    CrossrefPubMedGoogle Scholar
  • 15 Taylor S M. Electroconvulsive therapy, brain-derived neurotrophic factor, and possible neurorestorative benefit of the clinical application of electroconvulsive therapy.  J ECT. 2008;  24(2) 160-165
    CrossrefPubMedGoogle Scholar
  • 16 Dubovsky S L. Using electroconvulsive therapy for patients with neurological disease.  Hosp Community Psychiatry. 1986;  37(8) 819-825
    PubMedGoogle Scholar
  • 17 Krueger R B, Fama J M, Devanand D P, Prudic J, Sackeim H A. Does ECT permanently alter seizure threshold?.  Biol Psychiatry. 1993;  33(4) 272-276
    CrossrefPubMedGoogle Scholar
  • 18 Aarsland D, Larsen J P, Waage O, Langeveld J H. Maintenance electroconvulsive therapy for Parkinson's disease.  Convuls Ther. 1997;  13(4) 274-277
    PubMedGoogle Scholar
  • 19 Moellentine C, Rummans T A, Ahlskog J E et al.. Effectiveness of ECT in patients with parkinsonism.  J Neuropsychiatry Clin Neurosci. 1998;  10(2) 187-193
    PubMedGoogle Scholar
  • 20 Kennedy R, Mittal D, O'Jile J. Electroconvulsive therapy in movement disorders: an update.  J Neuropsychiatry Clin Neurosci. 2003;  15(4) 407-421
    PubMedGoogle Scholar
  • 21 Andrade C, Kurinji S. Continuation and maintenance ECT: a review of recent research.  J ECT. 2002;  18(3) 149-158
    CrossrefPubMedGoogle Scholar
  • 22 Weiner R D. American Psychiatric Association Committee on Electroconvulsive Therapy .The Practice of Electroconvulsive Therapy: Recommendations for Treatment, Training, and Privileging. Washington, DC; American Psychiatric Association 1990
    Google Scholar
  • 23 Dubovsky S L. Electroconvulsive therapy. In: Kaplan HI, Sadock BJ Comprehensive Textbook of Psychiatry/VI. 6th ed. Baltimore, MD; Williams and Wilkins 1995: 2129-2140
    Google Scholar
  • 24 Dannon P N, Dolberg O T, Schreiber S, Grunhaus L. Three and six-month outcome following courses of either ECT or rTMS in a population of severely depressed individuals—preliminary report.  Biol Psychiatry. 2002;  51(8) 687-690
    CrossrefPubMedGoogle Scholar
  • 25 Grunhaus L, Schreiber S, Dolberg O T, Polak D, Dannon P N. A randomized controlled comparison of electroconvulsive therapy and repetitive transcranial magnetic stimulation in severe and resistant nonpsychotic major depression.  Biol Psychiatry. 2003;  53(4) 324-331
    CrossrefPubMedGoogle Scholar
  • 26 Kozel F A, George M S. Meta-analysis of left prefrontal repetitive transcranial magnetic stimulation (rTMS) to treat depression.  J Psychiatr Pract. 2002;  8 270-275
    CrossrefPubMedGoogle Scholar
  • 27 Furukawa T A, Streiner D L, Young L T. Antidepressant and benzodiazepine for major depression.  Cochrane Database Syst Rev. 2002;  (1) CD001026
    PubMedGoogle Scholar
  • 28 Dubovsky S L. Agents acting on the benzodiazepine receptor. In: Sadock B, Sadock V, Ruiz P Comprehensive Textbook of Psychiatry. 9th ed. Baltimore, MD; Williams and Wilkins 2009
    Google Scholar
  • 29 Busto U, Sellers E M, Naranjo C A, Cappell H, Sanchez-Craig M, Sykora K. Withdrawal reaction after long-term therapeutic use of benzodiazepines.  N Engl J Med. 1986;  315(14) 854-859
    PubMedGoogle Scholar
  • 30 Brooks J O, Hoblyn J C. Neurocognitive costs and benefits of psychotropic medications in older adults.  J Geriatr Psychiatry Neurol. 2007;  20(4) 199-214
    CrossrefPubMedGoogle Scholar
  • 31 Smith D E, Wesson D R. Benzodiazepines and other sedative-hypnotics. In: Galanter M, Kleber HD American Psychiatric Press Textbook of Substance Abuse Treatment, 2nd ed. Washington, DC; American Psychiatric Press 1999: 239-250
    Google Scholar
  • 32 Smith D E, Wesson D R. Phenobarbital technique for treatment of barbiturate dependence.  Arch Gen Psychiatry. 1971;  24(1) 56-60
    PubMedGoogle Scholar
  • 33 Garfinkel D, Zisapel N, Wainstein J, Laudon M. Facilitation of benzodiazepine discontinuation by melatonin: a new clinical approach.  Arch Intern Med. 1999;  159(20) 2456-2460
    CrossrefPubMedGoogle Scholar
  • 34 Pande A C, Pollack M H, Crockatt J G et al.. Placebo-controlled study of gabapentin treatment of panic disorder.  J Clin Psychopharmacol. 2000;  20(4) 467-471
    CrossrefPubMedGoogle Scholar
  • 35 Pande A C, Feltner D E, Jefferson J W et al.. Efficacy of the novel anxiolytic pregabalin in social anxiety disorder: a placebo-controlled, multicenter study.  J Clin Psychopharmacol. 2004;  24(2) 141-149
    CrossrefPubMedGoogle Scholar
  • 36 Dubovsky S L. Agents acting on the benzodiazepine receptor. In: Sadock B, Sadock V, Ruiz P Comprehensive Textbook of Psychiatry. 10th ed. Baltimore, MD; Williams and Wilkins 2009
    Google Scholar
  • 37 Davis J M, Chen N, Glick I D. A meta-analysis of the efficacy of second-generation antipsychotics.  Arch Gen Psychiatry. 2003;  60(6) 553-564
    CrossrefPubMedGoogle Scholar
  • 38 Lieberman J A, Stroup T S, McEvoy J P Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Investigators et al. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia.  N Engl J Med. 2005;  353(12) 1209-1223
    CrossrefPubMedGoogle Scholar
  • 39 Jones P B, Barnes T R, Davies L et al.. Randomized controlled trial of the effect on quality of life of second- vs first-generation antipsychotic drugs in schizophrenia: Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study (CUtLASS 1).  Arch Gen Psychiatry. 2006;  63(10) 1079-1087
    CrossrefPubMedGoogle Scholar
  • 40 Marder S R, Essock S M, Miller A L et al.. The Mount Sinai conference on the pharmacotherapy of schizophrenia.  Schizophr Bull. 2002;  28(1) 5-16
    CrossrefPubMedGoogle Scholar
  • 41 Tohen M, Calabrese J R, Sachs G S et al.. Randomized, placebo-controlled trial of olanzapine as maintenance therapy in patients with bipolar I disorder responding to acute treatment with olanzapine.  Am J Psychiatry. 2006;  163(2) 247-256
    CrossrefPubMedGoogle Scholar
  • 42 Vieta E, Suppes T, Eggens I, Persson I, Paulsson B, Brecher M. Efficacy and safety of quetiapine in combination with lithium or divalproex for maintenance of patients with bipolar I disorder (international trial 126).  J Affect Disord. 2008;  109(3) 251-263
    CrossrefPubMedGoogle Scholar
  • 43 Allison D B, Mentore J L, Heo M et al.. Antipsychotic-induced weight gain: a comprehensive research synthesis.  Am J Psychiatry. 1999;  156(11) 1686-1696
    PubMedGoogle Scholar
  • 44 Gianfrancesco F D, Grogg A L, Mahmoud R A, Wang R H, Nasrallah H A. Differential effects of risperidone, olanzapine, clozapine, and conventional antipsychotics on type 2 diabetes: findings from a large health plan database.  J Clin Psychiatry. 2002;  63(10) 920-930
    Google Scholar
  • 45 American Diabetes Association . Consensus development conference on antipsychotic drugs and obesity and diabetes.  Diabetes Care. 2004;  27(2) 596-601
    CrossrefPubMedGoogle Scholar
  • 46 Reilly J G, Ayis S A, Ferrier I N, Jones S J, Thomas S HL. Thioridazine and sudden unexplained death in psychiatric in-patients.  Br J Psychiatry. 2002;  180 515-522
    CrossrefPubMedGoogle Scholar
  • 47 Ray W A, Chung C P, Murray K T, Hall K, Stein C M. Atypical antipsychotic drugs and the risk of sudden cardiac death.  N Engl J Med. 2009;  360(3) 225-235
    CrossrefPubMedGoogle Scholar
  • 48 Shale J H, Shale C M, Mastin W D. A review of the safety and efficacy of droperidol for the rapid sedation of severely agitated and violent patients.  J Clin Psychiatry. 2003;  64(5) 500-505
    PubMedGoogle Scholar
  • 49 Passmore M J, Gardner D M, Polak Y, Rabheru K. Alternatives to atypical antipsychotics for the management of dementia-related agitation.  Drugs Aging. 2008;  25(5) 381-398
    CrossrefPubMedGoogle Scholar
  • 50 Friedman J H. Atypical antipsychotics in the elderly with Parkinson disease and the “black box” warning.  Neurology. 2006;  67(4) 564-566
    CrossrefPubMedGoogle Scholar
  • 51 Rabins P V, Lyketsos C G. Antipsychotic drugs in dementia: what should be made of the risks?.  JAMA. 2005;  294(15) 1963-1965
    CrossrefPubMedGoogle Scholar
  • 52 Finkel S, Kozma C, Long S et al.. Risperidone treatment in elderly patients with dementia: relative risk of cerebrovascular events versus other antipsychotics.  Int Psychogeriatr. 2005;  17(4) 617-629
    CrossrefPubMedGoogle Scholar
  • 53 Kales H C, Valenstein M, Kim H M et al.. Mortality risk in patients with dementia treated with antipsychotics versus other psychiatric medications.  Am J Psychiatry. 2007;  164(10) 1568-1576, quiz 1623
    CrossrefPubMedGoogle Scholar
  • 54 Brodtkorb E, Mula M. Optimizing therapy of seizures in adult patients with psychiatric comorbidity.  Neurology. 2006;  67(12, Suppl 4) S39-S44
    CrossrefPubMedGoogle Scholar
  • 55 Kurlan R, Cummings J, Raman R, Thal L. Alzheimer's Disease Cooperative Study Group . Quetiapine for agitation or psychosis in patients with dementia and parkinsonism.  Neurology. 2007;  68(17) 1356-1363
    CrossrefPubMedGoogle Scholar
  • 56 Chacko R C, Hurley R A, Harper R G, Jankovic J, Cardoso F. Clozapine for acute and maintenance treatment of psychosis in Parkinson's disease.  J Neuropsychiatry Clin Neurosci. 1995;  7(4) 471-475
    PubMedGoogle Scholar
  • 57 Strawn J R, Keck Jr P EJ, Caroff S N. Neuroleptic malignant syndrome.  Am J Psychiatry. 2007;  164(6) 870-876
    CrossrefPubMedGoogle Scholar
  • 58 Panitch H S, Thisted R A, Smith R A Psuedobulbar Affect in Multiple Sclerosis Study Group et al. Randomized, controlled trial of dextromethorphan/quinidine for pseudobulbar affect in multiple sclerosis.  Ann Neurol. 2006;  59(5) 780-787
    CrossrefPubMedGoogle Scholar
  • 59 Loj J, Solomon G D. Migraine prophylaxis: who, why, and how.  Cleve Clin J Med. 2006;  73(9) 793-794, 797, 800–801 passim
    CrossrefPubMedGoogle Scholar
  • 60 Saarto T, Wiffen P J. Antidepressants for neuropathic pain.  Cochrane Database Syst Rev. 2007;  (4) CD005454
    PubMedGoogle Scholar
  • 61 Battaglia J, Lindborg S R, Alaka K, Meehan K, Wright P. Calming versus sedative effects of intramuscular olanzapine in agitated patients.  Am J Emerg Med. 2003;  21(3) 192-198
    CrossrefPubMedGoogle Scholar
  • 62 Battaglia J, Moss S, Rush J et al.. Haloperidol, lorazepam, or both for psychotic agitation? A multicenter, prospective, double-blind, emergency department study.  Am J Emerg Med. 1997;  15(4) 335-340
    Google Scholar
  • 63 Lukens T W, Wolf S J, Edlow J A American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Critical Issues in the Diagnosis and Management of the Adult Psychiatric Patient in the Emergency Department et al. Clinical policy: critical issues in the diagnosis and management of the adult psychiatric patient in the emergency department.  Ann Emerg Med. 2006;  47(1) 79-99
    CrossrefPubMedGoogle Scholar
  • 64 Zuidema S U, van Lersel M B, Koopmans R T, Verhey F R, Olde Rikkert M G. Efficacy and adverse reactions of antipsychotics for neuropsychiatric symptoms in dementia: a systematic review.  Ned Tijdschr Geneeskd. 2006;  150 1565-1573
    PubMedGoogle Scholar
  • 65 Miyaji S, Yamamoto K, Hoshino S, Yamamoto H, Sakai Y, Miyaoka H. Comparison of the risk of adverse events between risperidone and haloperidol in delirium patients.  Psychiatry Clin Neurosci. 2007;  61(3) 275-282
    CrossrefPubMedGoogle Scholar
  • 66 Riker R R, Fraser G L, Cox P M. Continuous infusion of haloperidol controls agitation in critically ill patients.  Crit Care Med. 1994;  22(3) 433-440
    CrossrefPubMedGoogle Scholar
  • 67 Fernandez F, Holmes V F, Adams F, Kavanaugh J J. Treatment of severe, refractory agitation with a haloperidol drip.  J Clin Psychiatry. 1988;  49(6) 239-241
    PubMedGoogle Scholar
  • 68 Hassaballa H A, Balk R A. Torsade de pointes associated with the administration of intravenous haloperidol: a review of the literature and practical guidelines for use.  Expert Opin Drug Saf. 2003;  2(6) 543-547
    PubMedGoogle Scholar
  • 69 Tisdale J E, Rasty S, Padhi I D, Sharma N D, Rosman H. The effect of intravenous haloperidol on QT interval dispersion in critically ill patients: comparison with QT interval prolongation for assessment of risk of torsades de pointes.  J Clin Pharmacol. 2001;  41(12) 1310-1318
    PubMedGoogle Scholar
  • 70 Schneider L S, Dagerman K S, Insel P S. Efficacy and adverse effects of atypical antipsychotics for dementia: meta-analysis of randomized, placebo-controlled trials.  Am J Geriatr Psychiatry. 2006;  14(3) 191-210
    CrossrefPubMedGoogle Scholar
  • 71 Schneider L S, Tariot P N, Dagerman K S CATIE-AD Study Group et al. Effectiveness of atypical antipsychotic drugs in patients with Alzheimer's disease.  N Engl J Med. 2006;  355(15) 1525-1538
    CrossrefPubMedGoogle Scholar
  • 72 Sultzer D L, Davis S M, Tariot P N CATIE-AD Study Group et al. Clinical symptom responses to atypical antipsychotic medications in Alzheimer's disease: phase 1 outcomes from the CATIE-AD effectiveness trial.  Am J Psychiatry. 2008;  165(7) 844-854
    CrossrefPubMedGoogle Scholar
  • 73 Selbaek G, Kirkevold Ø, Engedal K. The course of psychiatric and behavioral symptoms and the use of psychotropic medication in patients with dementia in Norwegian nursing homes—a 12-month follow-up study.  Am J Geriatr Psychiatry. 2008;  16(7) 528-536
    CrossrefPubMedGoogle Scholar
  • 74 Lavretsky H. Neuropsychiatric symptoms in Alzheimer disease and related disorders: why do treatments work in clinical practice but not in the randomized trials?.  Am J Geriatr Psychiatry. 2008;  16(7) 523-527
    CrossrefPubMedGoogle Scholar
  • 75 Pollock B G, Mulsant B H, Rosen J et al.. A double-blind comparison of citalopram and risperidone for the treatment of behavioral and psychotic symptoms associated with dementia.  Am J Geriatr Psychiatry. 2007;  15(11) 942-952
    CrossrefPubMedGoogle Scholar
  • 76 Dubovsky S L, Thomas M. Beyond specificity: effects of serotonin and serotonergic treatments on psychobiological dysfunction.  J Psychosom Res. 1995;  39(4) 429-444
    CrossrefPubMedGoogle Scholar
  • 77 Cantillon M, Brunswick R, Molina D, Bahro M. Buspirone vs haloperidol: a double-blind trial for agitation in a nursing home population with Alzheimer's disease.  Am J Geriatr Psychiatry. 1996;  4 263-267
    CrossrefPubMedGoogle Scholar
  • 78 Brooke M M, Patterson D R, Questad K A, Cardenas D, Farrel-Roberts L. The treatment of agitation during initial hospitalization after traumatic brain injury.  Arch Phys Med Rehabil. 1992;  73(10) 917-921
    PubMedGoogle Scholar
  • 79 Weiler P G, Mungas D, Bernick C. Propranolol for the control of disruptive behavior in senile dementia.  J Geriatr Psychiatry Neurol. 1988;  1(4) 226-230
    CrossrefPubMedGoogle Scholar
  • 80 Bearden C E, Thompson P M, Dalwani M et al.. Greater cortical gray matter density in lithium-treated patients with bipolar disorder.  Biol Psychiatry. 2007;  62(1) 7-16
    CrossrefPubMedGoogle Scholar
  • 81 Ramasubbu R, Kennedy S H. Factors complicating the diagnosis of depression in cerebrovascular disease, Part II—neurological deficits and various assessment methods.  Can J Psychiatry. 1994;  39(10) 601-607
    PubMedGoogle Scholar
  • 82 Ross E D. The aprosodias. Functional-anatomic organization of the affective components of language in the right hemisphere.  Arch Neurol. 1981;  38(9) 561-569
    PubMedGoogle Scholar
  • 83 Van Someren E JW, Kessler A, Mirmiran M, Swaab D F. Indirect bright light improves circadian rest-activity rhythm disturbances in demented patients.  Biol Psychiatry. 1997;  41(9) 955-963
    CrossrefPubMedGoogle Scholar
  • 84 Cornélissen G, Halberg F, Burioka N, Perfetto F, Tarquini R, Bakken E E. Do plasma melatonin concentrations decline with age?.  Am J Med. 2000;  109(4) 343-345
    PubMedGoogle Scholar
  • 85 Okuma T, Kishimoto A. A history of investigation on the mood stabilizing effect of carbamazepine in Japan.  Psychiatry Clin Neurosci. 1998;  52(1) 3-12
    CrossrefPubMedGoogle Scholar
  • 86 Freeman T W, Clothier J L, Pazzaglia P, Lesem M D, Swann A C. A double-blind comparison of valproate and lithium in the treatment of acute mania.  Am J Psychiatry. 1992;  149(1) 108-111
    PubMedGoogle Scholar
  • 87 Allen M H, Hirschfeld R M, Wozniak P J, Baker J D, Bowden C L. Linear relationship of valproate serum concentration to response and optimal serum levels for acute mania.  Am J Psychiatry. 2006;  163 272-275
    CrossrefPubMedGoogle Scholar
  • 88 Conway C R, Chibnall J T, Nelson L A et al.. An open-label trial of adjunctive oxcarbazepine for bipolar disorder.  J Clin Psychopharmacol. 2006;  26(1) 95-97
    CrossrefPubMedGoogle Scholar
  • 89 Ettinger A B. Psychotropic effects of antiepileptic drugs.  Neurology. 2006;  67(11) 1916-1925
    CrossrefPubMedGoogle Scholar
  • 90 Calabrese J R, Bowden C L, Sachs G Lamictal 605 Study Group et al. A placebo-controlled 18-month trial of lamotrigine and lithium maintenance treatment in recently depressed patients with bipolar I disorder.  J Clin Psychiatry. 2003;  64(9) 1013-1024
    CrossrefPubMedGoogle Scholar
  • 91 Bowden C L, Calabrese J R, Sachs G Lamictal 606 Study Group et al. A placebo-controlled 18-month trial of lamotrigine and lithium maintenance treatment in recently manic or hypomanic patients with bipolar I disorder.  Arch Gen Psychiatry. 2003;  60(4) 392-400
    CrossrefPubMedGoogle Scholar
  • 92 Reimers A, Skogvoll E, Sund J K, Spigset O. Drug interactions between lamotrigine and psychoactive drugs: evidence from a therapeutic drug monitoring service.  J Clin Psychopharmacol. 2005;  25(4) 342-348
    CrossrefPubMedGoogle Scholar
  • 93 Pande A C, Davidson J R, Jefferson J W et al.. Treatment of social phobia with gabapentin: a placebo-controlled study.  J Clin Psychopharmacol. 1999;  19(4) 341-348
    CrossrefPubMedGoogle Scholar
  • 94 Pohl R B, Feltner D E, Fieve R R, Pande A C. Efficacy of pregabalin in the treatment of generalized anxiety disorder: double-blind, placebo-controlled comparison of BID versus TID dosing.  J Clin Psychopharmacol. 2005;  25(2) 151-158
    CrossrefPubMedGoogle Scholar
  • 95 Feltner D E, Crockatt J G, Dubovsky S J et al.. A randomized, double-blind, placebo-controlled, fixed-dose, multicenter study of pregabalin in patients with generalized anxiety disorder.  J Clin Psychopharmacol. 2003;  23(3) 240-249
    CrossrefPubMedGoogle Scholar
  • 96 Roy Chengappa K N, Schwarzman L K, Hulihan J F, Xiang J, Rosenthal N R. Clinical Affairs Product Support Study-168 Investigators . Adjunctive topiramate therapy in patients receiving a mood stabilizer for bipolar I disorder: a randomized, placebo-controlled trial.  J Clin Psychiatry. 2006;  67(11) 1698-1706
    PubMedGoogle Scholar
  • 97 Kushner S F, Khan A, Lane R, Olson W H. Topiramate monotherapy in the management of acute mania: results of four double-blind placebo-controlled trials.  Bipolar Disord. 2006;  8(1) 15-27
    PubMedGoogle Scholar
  • 98 Vasudev K, Macritchie K, Geddes J R, Watson S, Young A H. Topiramate for acute affective episodes in bipolar disorder.  Cochrane Database Syst Rev. 2006;  (1) CD003384
    PubMedGoogle Scholar
  • 99 Krüger S, Sarkar R, Pietsch R, Hasenclever D, Bräunig P. Levetiracetam as monotherapy or add-on to valproate in the treatment of acute mania-a randomized open-label study.  Psychopharmacology (Berl). 2008;  198(2) 297-299
    CrossrefPubMedGoogle Scholar
  • 100 Post R M, Altshuler L L, Frye M A et al.. Preliminary observations on the effectiveness of levetiracetam in the open adjunctive treatment of refractory bipolar disorder.  J Clin Psychiatry. 2005;  66(3) 370-374
    PubMedGoogle Scholar
  • 101 Young A H, Geddes J R, Macritchie K, Rao S N, Vasudev A. Tiagabine in the maintenance treatment of bipolar disorders.  Cochrane Database Syst Rev. 2006;  (3) CD005173
    PubMedGoogle Scholar
  • 102 Ghaemi S N, Shirzadi A A, Klugman J, Berv D A, Pardo T B, Filkowski M M. Is adjunctive open-label zonisamide effective for bipolar disorder?.  J Affect Disord. 2008;  105(1-3) 311-314
    CrossrefPubMedGoogle Scholar
  • 103 Wang P W, Yang Y S, Chandler R A et al.. Adjunctive zonisamide for weight loss in euthymic bipolar disorder patients: a pilot study.  J Psychiatr Res. 2008;  42(6) 451-457
    CrossrefPubMedGoogle Scholar
  • 104 Corrigan M H, Denahan A Q, Wright C E, Ragual R J, Evans D L. Comparison of pramipexole, fluoxetine, and placebo in patients with major depression.  Depress Anxiety. 2000;  11(2) 58-65
    CrossrefPubMedGoogle Scholar
  • 105 Lattanzi L, Dell'Osso L, Cassano P et al.. Pramipexole in treatment-resistant depression: a 16-week naturalistic study.  Bipolar Disord. 2002;  4(5) 307-314
    CrossrefPubMedGoogle Scholar
  • 106 Perugi G, Toni C, Ruffolo G, Frare F, Akiskal H S. Adjunctive dopamine agonists in treatment-resistant bipolar II depression: an open case series.  Pharmacopsychiatry. 2001;  34(4) 137-141
    Article in Thieme ConnectPubMedGoogle Scholar
  • 107 Rush A J, Sackeim H A, Marangell L B et al.. Effects of 12 months of vagus nerve stimulation in treatment-resistant depression: a naturalistic study.  Biol Psychiatry. 2005;  58(5) 355-363
    CrossrefPubMedGoogle Scholar
  • 108 Rush A J, George M S, Sackeim H A et al.. Vagus nerve stimulation (VNS) for treatment-resistant depressions: a multicenter study.  Biol Psychiatry. 2000;  47(4) 276-286
    CrossrefPubMedGoogle Scholar
  • 109 Rush A J, Marangell L B, Sackeim H A et al.. Vagus nerve stimulation for treatment-resistant depression: a randomized, controlled acute phase trial.  Biol Psychiatry. 2005;  58(5) 347-354
    CrossrefPubMedGoogle Scholar
  • 110 Sackeim H A, Brannan S K, Rush A J, George M S, Marangell L B, Allen J. Durability of antidepressant response to vagus nerve stimulation (VNS).  Int J Neuropsychopharmacol. 2007;  10(6) 817-826
    PubMedGoogle Scholar
  • 111 Lozano A M, Mayberg H S, Giacobbe P, Hamani C, Craddock R C, Kennedy S H. Subcallosal cingulate gyrus deep brain stimulation for treatment-resistant depression.  Biol Psychiatry. 2008;  64(6) 461-467
    CrossrefPubMedGoogle Scholar
  • 112 Mallet L, Polosan M, Jaafari N et al.. Subthalamic nucleus stimulation in severe obsessive-compulsive disorder.  N Engl J Med. 2008;  359 2121-2134
    CrossrefPubMedGoogle Scholar

Steven L DubovskyM.D. 

462 Grider Street

Buffalo, NY 14215

Email: dubovsky@buffalo.edu

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