Table Of ContentPharmacotherapy
for Mood, Anxiety,
and Cognitive
Disorders
This page intentionally left blank
Pharmacotherapy
for Mood, Anxiety,
and Cognitive
Disorders
Editedby
Uriel Halbreich, M.D.
Stuart A. Montgomery, M.D.
Washington, DC
London, England
Note: Theauthorshaveworkedtoensurethatallinformationinthisbookcon-
cerningdrugdosages,schedules,androutesofadministrationisaccurateasofthe
timeofpublicationandconsistentwithstandardssetbytheU.S.FoodandDrug
Administrationandthegeneralmedicalcommunity.Asmedicalresearchandprac-
ticeadvance,however,therapeuticstandardsmaychange.Forthisreasonandbe-
causehumanandmechanicalerrorssometimesoccur,werecommendthatreaders
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memberoftheirfamily.
BookspublishedbytheAmericanPsychiatricPress,Inc.,representtheviewsand
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LibraryofCongressCataloging-in-PublicationData
Pharmacotherapyformood,anxiety,andcognitivedisorders/editedby
UrielHalbreich,StuartMontgomery.
p. cm.
Includesbibliographicalreferencesandindex.
ISBN0-88048-885-9
1.Affectivedisorders—Chemotherapy. 2.Cognitiondisorders—
Chemotherapy. I.Halbreich,Uriel,1943– . II.Montgomery,S.
A.
[DNLM:1.MoodDisorders—drugtherapy. 2.Cognition
Disorders—drugtherapy. 3.AntidepressiveAgents—therapeuticuse. 4.Anti-
AnxietyAgents—therapeuticuse. WM171P53551999]
RC537.P456 1999
616.85′27061—dc21
DNLM/DLC
forLibraryofCongress 99-13399
CIP
BritishLibraryCataloguinginPublicationData
ACIPrecordisavailablefromtheBritishLibrary.
Contents
Contributors. . . . . . . . . . . . . . . . . . . . . . . . . xiii
Section I
Overviews
1
PharmacotherapyforMood,Anxiety,and
CognitiveDisorders:AnOverview . . . . . . . . . . . . . . 3
UrielHalbreich,M.D.
2
CurrentTheoriesonthePathophysiologyof
MoodDisorders . . . . . . . . . . . . . . . . . . . . . . . 13
FlorianHolsboer,M.D.,Ph.D.
3
PharmacologicalValidityofDiagnosticSeparation . . . . . 37
YvonD.Lapierre,M.D.,F.R.C.P.C.,
DavidBakish,M.D.,F.R.C.P.C.,and
CynthiaL.Hooper,M.A.
4
SignalAmplificationinPsychiatricDiagnosis:
AQuintessentialChallengeforBiologicalPsychiatry . . . . 45
HermanM.VanPraag,M.D.,Ph.D.
5
GenderDifferencesinTreatmentof
DepressionandAnxiety . . . . . . . . . . . . . . . . . . . 59
KimberlyA.Yonkers,M.D.,JudyC.Kando,Pharm.D.,
JeanA.Hamilton,M.D.,andUrielHalbreich,M.D.
Section II
Mood Stabilizers
Robert M. Post, M.D., Section Editor
6
CarbamazepineandNimodipineinRefractory
BipolarIllness:EfficacyandMechanisms . . . . . . . . . . 77
RobertM.Post,M.D.,PeggyJ.Pazzaglia,M.D.,TerenceA.Ketter,
M.D.,KirkDenicoff,M.D.,SusanR.B.Weiss,Ph.D.,ChrisHough,
Ph.D.,De-MawChuang,Ph.D.,RobynStein,M.D.,andMarkFrye,
M.D.
7
MechanismsofActionofLithiuminBipolarDisorder. . . 111
HusseiniK.Manji,M.D.,RobertK.McNamara,Ph.D.,and
RobertH.Lenox,M.D.
8
ClinicalEfficacyofValproateinBipolarIllness:
ComparisonsandContrastsWithLithium. . . . . . . . . 143
StephenM.Strakowski,M.D.,SusanL.McElroy,M.D.,and
PaulE.KeckJr.,M.D.
9
TherapeuticPotentialofInositolTreatmentinDepression,
Panic,Dementia,andLithiumSideEffects. . . . . . . . . 159
JosephLevine,M.D.,YoramBarak,M.D.,
JonathanBenjamin,M.D.,YulyBersudsky,M.D.,
OraKofman,Ph.D.,andRobertH.Belmaker,M.D.
10
ElectroconvulsiveTherapy:
CurrentPracticeandFutureDirections . . . . . . . . . . 167
MitchellS.Nobler,M.D.,HaroldA.Sackeim,Ph.D.,and
DavangereP.Devanand,M.D.
11
AntidepressantandMoodStabilization
PotentialofTranscranialMagneticStimulation . . . . . . 189
AmosFleischmann,Ph.D.,DanielSilverberg,M.D.,and
RobertH.Belmaker,M.D.
Section III
Antidepressants
Alan F. Schatzberg, M.D., Section Editor
12
ChangingTargetsofAntidepressantTherapy:
SerotoninandBeyond . . . . . . . . . . . . . . . . . . . 199
StuartA.Montgomery,M.D.
13
NewEmergingSerotonergicAntidepressants . . . . . . . 213
JoginH.Thakore,Ph.D.,M.R.C.Psych.,
CarloBerti,M.B.,M.F.P.M.,and
TimothyG.Dinan,M.D.,Ph.D.,F.R.C.P.I.,F.R.C.Psych.
14
DopamineReceptorsandAntidepressantDevelopment . . 221
RogerM.Pinder,Ph.D.,D.Sc.
15
NoradrenergicandOtherNewAntidepressants . . . . . . 237
WilliamZ.Potter,M.D.,Ph.D.,and
MarkE.Schmidt,M.D.
16
SleepinDepressionandtheEffectsof
AntidepressantsonSleep . . . . . . . . . . . . . . . . . . 255
ConstantinR.Soldatos,M.D.,and
JoanneD.Bergiannaki,M.D.
17
HormonalInterventionsasAntidepressantsor
AdjunctTherapy:TreatmentImplications . . . . . . . . . 273
UrielHalbreich,M.D.
18
MechanismsandManagementof
Treatment-ResistantDepression . . . . . . . . . . . . . . 285
JohnP.O’Reardon,M.D.,andJayD.Amsterdam,M.D.
19
TreatmentofPsychoticDepression. . . . . . . . . . . . . 305
CharlesDeBattista,D.M.H.,M.D.,
JosephK.Belanoff,M.D.,andAlanF.Schatzberg,M.D.
20
AntidepressantMaintenanceMedications . . . . . . . . . 315
JohnF.Greden,M.D.
Section IV
Anxiolytics
Stephen M. Stahl, M.D., Ph.D., Section Editor
21
OverviewofNewAnxiolytics. . . . . . . . . . . . . . . . 333
StephenM.Stahl,M.D.,Ph.D,LewisL.Judd,M.D.,and
JelenaL.Kunovac,M.D.
22
InteractionsBetweenPhysiological,Hormonal,and
EnvironmentalDeterminants:TheAnxietyModel . . . . . 341
DanielS.Pine,M.D.,JeremyD.Coplan,M.D.,
LaszloA.Papp,M.D.,andJackM.Gorman,M.D.
23
Serotonin-SpecificAnxiolytics:NowandintheFuture . . 355
JelenaL.Kunovac,M.D.,and
StephenM.Stahl,M.D.,Ph.D.
24
SerotonergicTreatmentsforPanicDisorder . . . . . . . . 367
HermanG.M.Westenberg,Ph.D.,and
JohanA.DenBoer,M.D.
25
NewTreatmentsforSocialPhobia . . . . . . . . . . . . . 383
CherriM.Miner,M.D.,M.B.A.,
KatherineM.Connor,M.D.,and
JonathanR.T.Davidson,M.D.
26
WhyaPeptideasanAnxiolytic? . . . . . . . . . . . . . . 399
GaryD.Tollefson,M.D.,Ph.D.
27
CholecystokininAntagonistsin
PanicandAnxietyDisorders . . . . . . . . . . . . . . . . 411
JacquesBradwejn,M.D.,F.R.C.P.C.,DianaKoszycki,Ph.D.,
EeroVasar,M.D.,Ph.D.,RobertaPalmour,Ph.D.,and
FrancoVaccarino,Ph.D.
28
Neurosteroids. . . . . . . . . . . . . . . . . . . . . . . . 439
IsabellaHeuser,M.D.
Description:Our limited knowledge of the pathophysiology underlying mood disorders contrasts sharply with the efficacy of the treatment modalities developed over the past decades. There has been an explosion of new antidepressant and anxiolytic medications, as well as mood stabilizers and compounds that aim to
