Skip to main content Accessibility help
  • Print publication year: 2008
  • Online publication date: May 2010

27 - Psychopharmacology of mood disorders

from Part III - Specific treatments


Editorial note

As depression has been identified as the fourth leading cause of disease burden, accounting for 12% of total disability worldwide (Üstün et al., 2004), and because drug treatment is one of the most widely used, this chapter is a very important one. There are several messages that need to be disseminated from this chapter. Firstly, antidepressant drugs, despite many improvements over the years, remain drugs with many adverse effects, and selection of a drug is likely to be determined more by its adverse effect profile than by its efficacy rating. Next, depression is often combined with other disorders, and treatment must take into account the nature of these other conditions and the effect of drug treatment upon them. A third message is very important to clinicians; do not increase the dose of an antidepressant too readily. Response, particularly the full response, to an antidepressant is often delayed, and rushing to a high dose will only add to adverse effects at a time when the patient is not well prepared to deal with them. The treatment of bipolar disorder is associated with more controversy than depression alone, especially in the maintenance phase, and here there is a difference between recommendations in the United States and those of other countries, with much greater use of a typical antipsychotics and sodium valproate in the USA and more emphasis on lithium elsewhere, with bigger differences in the maintenance than acute phases of treatment.

Related content

Powered by UNSILO
Agid, O. & Lerer, B. (2003). Algorithm-based treatment of major depression in an outpatient clinic: clinical correlates of response to a specific serotonin reuptake inhibitor and to triiodothyronine augmentation. International Journal of Neuropsychopharmacology, 6(1), 41–9.
Ahlfors, U. G., Baastrup, P. al. (1981). Flupenthixol decanoate in recurrent manic-depressive illness. Acta Psychiatrica Scandinavica 64, 226–37.
Altshuler, L. L., Bauer, al. (2001a). Does thyroid supplementation accelerate tricyclic antidepressant response? A review and meta-analysis of the literature. American Journal of Psychiatry, 158(10), 1617–22.
Altshuler, L., Kiriakos, al. (2001b). The impact of antidepressant discontinuation versus antidepressant continuation on 1-year risk for relapse of bipolar depression: a retrospective chart review. Journal of Clinical Psychiatry, 62(8), 612–16.
American Psychiatric Association (2002). Practice guideline for the treatment of patients with bipolar disorder (revision). American Journal of Psychiatry, 159, 1–50.
Atmaca, M., Kuloglu, al. (2002). The efficacy of citalopram in the treatment of premature ejaculation: a placebo-controlled study. International Journal of Impotency Research, 14(6), 502–5.
Avery, D. & Winokur, G. (1977). The efficacy of electroconvulsive therapy and antidepressants in depression. Biological Psychiatry, 12(4), 507–23.
Baca, E., Garcia-Garcia, al. (2004). Gender differences in treatment response to sertraline versus imipramine in patients with nonmelancholic depressive disorders. Progress in Neuropsychopharmacology and Biolical Psychiatry, 28(1), 57–65.
Ballenger, J. C. & Post, R. M. (1978). Therapeutic effects of carbamazepine in affective illness: a preliminary report. Community Psychopharmacology, 2(2), 159–75.
Ballesteros, J. & Callado, L. F. (2004). Effectiveness of pindolol plus serotonin uptake inhibitors in depression: a meta-analysis of early and late outcomes from randomised controlled trials. Journal of Affective Disorders, 79(1–3), 137–47.
Barrett, J. E., Williams, J. W. al. (2001). Treatment of dysthymia and minor depression in primary care: a randomized trial in patients aged 18 to 59 years. Journal of Family Practice, 50(5), 405–12.
Bauer, M. & Dopfmer, S. (1999). Lithium augmentation in treatment-resistant depression: meta-analysis of placebo-controlled studies. Journal of Clinical Psychopharmacology, 19(5), 427–34.
Bauer, M., Linden, al. (1996). Adverse events and tolerability of the combination of fluoxetine/lithium compared with fluoxetine. Journal of Clinical Psychopharmacology, 16(2), 130–4.
Bauer, M., Bschor, al. (2000). Double-blind, placebo-controlled trial of the use of lithium to augment antidepressant medication in continuation treatment of unipolar major depression. American Journal of Psychiatry, 157(9), 1429–35.
Baumann, P., Nil, al. (1996). A double-blind, placebo-controlled study of citalopram with and without lithium in the treatment of therapy-resistant depressive patients: a clinical, pharmacokinetic, and pharmacogenetic investigation. Journal of Clinical Psychopharmacology, 16(4), 307–14.
Benkert, O., Szepedi, al. (1997). Dose escalation versus continued doses of paroxetine and maprotiline: a prospective study in depressed outpatients with an adequate treatment response. Acta Psychiatrica Scandinavica, 95, 288–96.
Biggs, J. T., Chang, S. al. (1976). Measurement of tricyclic antidepressant levels in an outpatient clinic. Journal of Nervous and Mental Diseases, 162(1), 46–51.
Bodkin, J. A., Lasser, R. al. (1997). Combining serotonin reuptake inhibitors and bupropion in partial responders to antidepressant monotherapy. Journal of Clinical Psychiatry, 58(4), 137–45.
Bowden, C. L., Brugger, A. al. (1994). Efficacy of divalproex vs lithium and placebo in the treatment of mania. The Depakote Mania Study Group. Journal of the American Medical Association, 271(12), 918–24.
Bowden, C. L., Calabrese, J. al. (2000). A randomized, placebo-controlled 12-month trial of divalproex and lithium in treatment of outpatients with bipolar I disorder. Archives of General Psychiatry, 57, 481–9.
Bowden, C. L., Calabrese, J. al. (2003). A placebo controlled 18-month trial of lamotrigine and maintenance treatment in recently manic or hypomanic patients with bipolar I disorder. American Journal of Psychiatry, 60, 392–400.
Brown, W. A., Johnson, M. al. (1992). Clinical features of depressed patients who do and do not improve with placebo. Psychiatry Research, 41(3), 203–14.
Calabrese, J. R., Bowden, C. al. (1999). A double-blind placebo-controlled study of lamotrigine monotherapy in outpatients with bipolar I depression. Lamictal 602 Study Group. Journal of Clinical Psychiatry, 60(2), 79–88.
Calabrese, J. R., Suppes, al. (2000). A double-blind, placebo-controlled, prophylaxis study of lamotrigine in rapid-cycling bipolar disorder. Lamictal 614 Study Group. Journal of Clinical Psychiatry, 61(11), 841–50.
Calabrese, J. R., Sullivan, J. al. (2002). Rash in multicenter trials of lamotrigine in mood disorders: clinical relevance and management. Journal of Clinical Psychiatry, 63(11), 1012–19.
Calabrese, J. R., Bowden, C. al. (2003). A placebo-controlled 18-month trial of lamotrigine and lithium maintenance treatment in recently depressed patients with bipolar I disorder. Journal of Clinical Psychiatry, 64(9), 1013–24.
Calabrese, J., Macfadden, al. (2005). Double-blind, placebo-controlled study of quetiapine in bipolar depression. American Journal of Psychiatry, 162, 1351–60.
Carpenter, L. L., Yasmin, al. (2002). A double-blind, placebo-controlled study of antidepressant augmentation with mirtazapine. Biological Psychiatry, 51(2), 183–8.
Chisholm, D., Sanderson, K., Ayuso-Mateos, J. L. & Saxena, S. (2004). Reducing the global burden of depression: population-level analysis of intervention cost-effectiveness in 14 world regions. British Journal of Psychiatry, 184, 393–403.
Coccaro, E. F. & Kavoussi, R. J. (1997). Fluoxetine and impulsive aggressive behavior in personality-disordered subjects. Archives of General Psychiatry, 54(12), 1081–8.
Cohn, J. B., Collins, al. (1989). A comparison of fluoxetine, imipramine and placebo in patients with bipolar depressive disorder. International Clinical Psychopharmacology, 4, 313–22.
Cole, D. P., Thase, M. al. (2002). Slower treatment response in bipolar depression predicted by lower pretreatment thyroid function. American Journal of Psychiatry, 159, 116–21.
Coryell, W. (2002). Minimizing the side effects of mood stabilizers. Primary Psychiatry, 9, 47–50.
Coryell, W., Coppen, al. (1982). Early improvement as a predictor of response to amitriptyline and nortriptyline: a comparison of 2 patient samples. Psychological Medicine, 12(1), 135–9.
Coryell, W., Akiskal, H. al. (1994). The time course of nonchronic major depressive disorder: uniformity across episodes and samples. Archives of General Psychiatry, 51(5), 405–10.
Coryell, W., Endicott, al. (1995). Characteristics and significance of untreated major depressive disorder. American Journal of Psychiatry, 152(8), 1124–9.
Coryell, W., Solomon, al. (2003). The long-term course of rapid cycling bipolar disorder. Archives of General Psychiatry. 60: 914–20.
Dawson, R., Lavori, P. al. (1998). Maintenance strategies for unipolar depression: an observational study of levels of treatment and recurrence. Journal of Affective Disorders, 49(1), 31–44.
Denicoff, K. D., Smith-Jackson, E. al. (1987). Comparative prophylactic efficacy of lithium, carbamazepine and the combination in bipolar disorder. Journal of Clinical Psychiatry, 58, 470–8.
Doogan, D. P. & Caillard, V. (1992). Sertraline in the prevention of depression. British Journal of Psychiatry, 160, 217–22.
Downing, R. W. & Rickels, K. (1973). Predictors of response to amitriptyline and placebo in three outpatient treatment settings. Journal Nervons and Mental Diseases 156(2), 109–29.
Fairchild, C. J., Rush, A. al. (1986). Which depressions respond to placebo?Psychiatry Research, 18(3), 217–26.
Fava, M., Labbate, L. al. (1995). Hypothyroidism and hyperthyroidism in major depression revisited. Journal of Clinical Psychiatry, 56, 186–92.
Fava, M., Alpert, al. (2002). Double-blind study of high-dose fluoxetine versus lithium or desipramine augmentation of fluoxetine in partial responders and nonresponders to fluoxetine. Journal of Clinical. Psychopharmacology, 22(4), 379–87.
Fava, M., Rush, A. J., Wisniewski, S. al. (2006). A comparison of mirtazapine and nortriptyline following two consecutive failed medication treatments for depressed outpatients: a STAR∗D report. American Journal of Psychiatry, 163(7), 1161–72.
Ferreri, M., Lavergne, al. (2001). Benefits from mianserin augmentation of fluoxetine in patients with major depression non-responsive to fluoxetine alone. Acta Psychiatrica Scandinavica, 103(1), 66–72.
Frank, E., Kupfer, D. al. (1990). Three-year outcomes for maintenance therapies in recurrent depression. Archives of General Psychiatry, 47(12), 1093–9.
Frankle, W. G., Perlis, R. al. (2002). Bipolar depression: relationship between episode length and antidepressant treatment. Psychological Medicine, 32(8), 1417–23.
Freeman, T. W., Clothier, J. al. (1992). A double-blind comparison of valproate and lithium in the treatment of acute mania. American Journal of Psychiatry, 149(1): 108–11.
Gelenberg, A. J., Kane, J. al. (1989). Comparison of standard and low serum levels of lithium for maintenance treatment of bipolar disorder. New England Journal of Medicine, 321(22), 1489–93.
Geddes, J. R., Rendell, J. M. & Goodwin, G. M. (2002). BALANCE: a large simple trial of maintenance treatment for bipolar disorder. World Psychiatry, 1, 48–51.
Geddes, J. R., Carney, S. M., Davies, al. (2003). Relapse prevention with antidepressant drug treatment in depressive disorders: a systematic review. Lancet, 361, 653–61.
Geddes, J. R., Burgess, S., Hawton, K., Jamison, K. & Goodwin, G. M. (2004). Long-term lithium therapy for bipolar disorder: systematic review and meta-analysis of randomized controlled trials. American Journal of Psychiatry, 161, 217–22.
Geddes, J. R, Goodwin, G. M.Huffman, R., Paska, W., Evoniuk, G. & Leadbetter, R. (2006). Additional clinical trial data and a retrospective pooled analysis of response rates across alll randomised trials conducted by GSK. Bipolar Disorders, 8 (Suppl. 1), 32.
Ghaemi, S. N., Lenox, M. S. & Baldessarini, R. J. (2001). Effectiveness and safety of long-term antidepressant treatment in bipolar disorder. Journal of Clinical Psychiatry, 62, 565–9.
Ghamei, S. N., Rosenquist, K. al. (2004). Antidepressant treatment in bipolar versus unipolar depression. American Journal of Psychiatry, 161, 163–5.
Gijsman, H. J., Geddes, J. R., Rendell, J. M., Nolen, W. A. & Goodwin, G. M. (2003). Antidepressants for bipolar depression: a systematic review of randomised controlled trials. American Journal of Psychiatry,
Gitlin, M. J., Weiner, al. (1987). Failure of T3 to potentiate tricyclic antidepressant response. Journal of Affective Disorders, 13(3), 267–72.
Glassman, A. H., Perel, J. al. (1977). Clinical implications of imipramine plasma levels for depressive illness. Archives of General Psychiatry, 34(2), 197–204.
Goldberg, J. F., Garno, J. al. (1998). Rapid titration of mood stabilizers predicts remission from mixed or pure mania in bipolar patients. Journal of Clinical Psychiatry, 59(4), 151–8.
Goldberg, J. F., Burdick, K. al. (2004). Preliminary randomized, double-blind, placebo-controlled trial of pramipexole added to mood stabilizers for treatment-resistant bipolar depression. American Journal of Psychiatry, 161(3), 564–6.
Goodwin, F. K. (2002). Rationale for long-term treatment of bipolar disorder and evidence for long-term lithium treatment. Journal of Clinical Psychiatry, 63(Suppl.), 5–12.
Goodwin, G. M. (2003). Evidence-based guidelines for treating bipolar disorder: recommendations from the British Association for Psychopharmacology. Journal of Psychopharmacology 17, 149–73.
Goodwin, F. K., Murphy, D. al. (1969). Lithium-carbonate treatment in depression and mania. A longitudinal double-blind study. Archives of General Psychiatry, 21(4), 486–96.
Grigoriadis, S., Kennedy, S. al. (2003). A comparison of antidepressant response in younger and older women. Journal of Clinical Psychopharmacology, 23(4), 405–7.
Himmelhoch, J. M., Fuchs, C. al. (1982). A double-blind study of tranylcypromine treatment of major anergic depression. Journal of Nervous and Mental Diseases 170(10), 628–34.
Hochstrasser, B., Isaksen, P. al. (2001). Prophylactic effect of citalopram in unipolar, recurrent depression: placebo-controlled study of maintenance therapy. British Journal of Psychiatry, 178, 304–10.
Hoehn-Saric, R., Lipsey, J. al. (1990). Apathy and indifference in patients on fluvoxamine and fluoxetine. Journal of Clinical Psychopharmacology, 10(5), 343–5.
Joffe, R. T. & Levitt, A. J. (1992). Major depression and subclinical (grade 2) hypothyroidism. Psychoneuroendocrinology, 17(2–3), 215–21.
Joffe, R. T. & Schuller, D. R. (1993). An open study of buspirone augmentation of serotonin reuptake inhibitors in refractory depression. Journal of Clinical Psychiatry, 54(7), 269–71.
Joffe, R. T. & Singer, W. (1990). A comparison of triiodothyronine and thyroxine in the potentiation of tricyclic antidepressants. Psychiatry Research, 32(3), 241–51.
Joffe, R. T., Singer, al. (1993). A placebo-controlled comparison of lithium and triiodothyronine augmentation of tricyclic antidepressants in unipolar refractory depression. Archives of General Psychiatry, 50(5), 387–93.
Joffe, R. T., MacQueen, G. al. (2002). Induction of mania and cycle acceleration in bipolar disorder: effect of different classes of antidepressant. Acta Psychiatrica Scandinavica, 105(6), 427–30.
Joffe, R. T., MacQueen, G. M., Marriot, M. & Young, L. T. (2005). One-year outcome with antidepressant treatment of bipolar depression. Acta Psychiatrica Scandinavica, 112, 105–9.
Joyce, P. R., Mulder, R. al. (2003). A differential response to nortriptyline and fluoxetine and melancholic depression: the importance of age and gender. Acta Psychiatrica Scandinavica, 108, 20–3.
Judd, L. L., Akiskal, H. al. (1998). Major depressive disorder: a prospective study of residual subthreshold depressive symptoms as predictor of rapid relapse. Journal of Affective Disorders, 50(2–3), 97–108.
Judd, L. L., , A. H. S., et al. (2002). The long-term natural history of the weekly symptomatic status of bipolar I disorder. Archives of General Psychiatry, 59, 530–7.
Judd, L. L., Schettler, P. al. (2003). Long-term symptomatic status of bipolar I versus bipolar II disorders. International Journal of Neuropsychopharmacology, 6, 127–37.
Katona, C. L., Abou-Saleh, M. al. (1995). Placebo-controlled trial of lithium augmentation of fluoxetine and lofepramine. British Journal of Psychiatry 166(1): 80–6.
Katz, M. M., Koslow, S. al. (1987). The timing, specificity and clinical prediction of tricyclic drug effects in depression. Psychological Medicine, 17(2), 297–309.
Keller, M. B., Kocsis, J. al. (1998). Maintenance phase efficacy of sertraline for chronic depression: a randomized controlled trial. Journal of the American Medical Association, 280(19), 1665–72.
Kelsey, J. E. (1996). Dose-response relationship with venlafaxine. Journal of Clinical Psychopharmacol 16(3 Suppl 2): 21S–6S; discussion 26S–8S.
Kennedy, S. H., McCann, S. al. (2002). Combining bupropion SR with venlafaxine, paroxetine, or fluoxetine: a preliminary report on pharmacokinetic, therapeutic, and sexual dysfunction effects. Journal of Clinical Psychiatry, 63(3), 181–6.
Ketter, T. A., Kalali, A. al. (2004). A 6-month, multicenter, open-label evaluation of beaded, extended-release carbamazepine capsule monotherapy in bipolar disorder patients with manic or mixed episodes. Journal of Clinical Psychiatry, 65(5), 668–73.
Khan, A., Dager, S. al. (1991). Chronicity of depressive episode in relation to antidepressant – placebo response. Neuropsychopharmacology, 4, 125–30.
Khan, A., Leventhal, R. al. (2002). Severity of depression and response to antidepressants and placebo: analysis of the Food and Drug Administration database. Journal of Clinical Psychopharmacology, 22, 40–5.
Kleindienst, N. & Greil, W. (2002). Inter-episodic morbidity and drop-out under carbamazepine and lithium in the maintenance treatment of bipolar disorder. Psychological Medicine, 32(3), 493–501.
Kocsis, J. H., Friedman, R. al. (1996). Maintenance therapy for chronic depression. A controlled clinical trial of desipramine. Archives of General Psychiatry, 53(9), 769–74; discussion 775–6.
Kornstein, S. G., Schatzberg, A. al. (2000). Gender differences in treatment response to sertraline versus imipramine in chronic depression. American Journal of Psychiatry, 157(9), 1445–52.
Koukopoulos, A., Sani, al. (2003). Duration and stability of the rapid-cycling course: a long-term personal follow-up of 109 patients. Journal of Affective Disorders 73, 75–85.
Kragh-Sorensen, P. & Hansen, E. (1976). Self inhibiting action of nortriptyline antidepressive effect at high plasma levels. Psychopharmacologia, 45, 305–12.
Kupfer, D. J. & Spiker, D. G. (1981). Refractory depression: prediction of non-response by clinical indicators. Journal of Clinical Psychiatry, 42(8), 307–12.
Laupacis, A., Sackett, D. L. & Roberts, R. S. (1988). An assessment of clinically useful measures of the consequences of treatment. New England Journal of Medicine, 318, 1728–33.
Lepine, J. P., Caillard, al. (2004). A randomized, placebo-controlled trial of sertraline for prophylactic treatment of highly recurrent major depressive disorder. American Journal of Psychiatry, 161(5), 836–42.
Licht, R. W. & Quitzau, S. (2002). Treatment strategies in patients with major depression not responding to first-line sertraline treatment. Psychopharmacology, 161, 143–51.
MacRitchie, K., Geddes, J. R., Scott, J., Haslam, D. R. & Goodwin, G. M. (2000a). Valproic acid, valproate and divalproex for acute mood episodes in bipolar disorder. Cochrane Library 4[4].
MacRitchie, K., Geddes, J. R., Scott, J., Haslam, D. R. & Goodwin, G. M. (2000b). Valproic acid, valproate and divalproex in the maintenance therapy of bipolar disorder. Cochrane Library 4[4].
Maj, M., Starace, al. (1986). Minimum plasma lithium levels required for effective prophylaxis in DSM III bipolar disorder: a prospective study. Pharmacopsychiatry, 19(6), 420–3.
Markovitz, P. (1995). Pharmacotherapy of Impulsivity, Aggression and Related Disorders. Chichester, UK: John Wiley.
Montgomery, S. A., Dufour, al. (1988). The prophylactic efficacy of fluoxetine in unipolar depression. British Journal of Psychiatry, Suppl. (3), 69–76.
Mueller, T. I., Lavori, P. al. (1994). Prognostic effect of the variable course of alcoholism on the 10-year course of depression. American Journal of Psychiatry, 151(5), 701–6.
Muller-Oerlinghausen, B., Retzow, al. (2000).Valproate as an adjunct to neuroleptic medication for the treatment of acute episodes of mania: a prospective, randomized, double-blind, placebo-controlled, multicenter study. Journal of Clinical Psychopharmacol, 20(2), 195–203.
Nagayama, H., Nagano, al. (1991). Prediction of efficacy of antidepressant by 1-week test therapy in depression. Journal of Affective Disorders, 23(4), 213–16.
Nelson, J. C., Mazure, C. al. (2004). Combining norepinephrine and serotonin reuptake inhibition mechanisms for treatment of depression: a double-blind, randomized study. Biological Psychiatry, 55(3), 296–300.
Nemeroff, C. B., Evans, D. al. (2001). Double-blind, placebo-controlled comparison of imipramine and paroxetine in the treatment of bipolar depression. American Journal of Psychiatry, 158, 906–12.
Nierenberg, A. A., McLean, N. al. (1995). Early non-response to fluoxetine as a predictor of poor eight-week outcome. American Journal of Psychiatry, 152, 1500–03.
Nierenberg, A. A., Fava, M., Trivedi, M. al. (2006). A comparison of lithinm and T(3) augmentation following two failed medication treatments for depression: a STAR∗D report. American Journal of psychiatry, 163(9), 1519–30.
Parker, G. (2002). Differential effectiveness of newer and older antidepressants appears mediated by an age effect on the phenotypic expression of depression. Acta Psychiatrica Scandinavica, 106(3), 168–70.
Parker, G., Parker, al. (2003). Gender differences in response to differing antidepressant drug classes: two negative studies. Psychological Medicine, 33(8), 1473–7.
Paykel, E. S., Hollyman, J. al. (1988). Predictors of therapeutic benefit from amitriptyline in mild depression: a general practice placebo-controlled trial. Journal of Affective Disorders, 14(1), 83–95.
Perry, A., Tarrier, al. (1999). Randomized controlled trial of efficacy of teaching patients with bipolar disorder to identify early symptoms of relapse and obtain treatment. British Medical Journal, 318, 149–53.
Pope, H. G. Jr, McElroy, S. al. (1991). Valproate in the treatment of acute mania. A placebo-controlled study. Archives of General Psychiatry, 48(1), 62–8.
Prien, R. F., Kupfer, D. al. (1984). Drug therapy in the prevention of recurrences in unipolar and bipolar affective disorders. Report of the NIMH Collaborative Study Group comparing lithium carbonate, imipramine, and a lithium carbonate-imipramine combination. Archives of General Psychiatry, 41(11), 1096–104.
Prohaska, M. L., Stern, R. al. (1995). Thyroid hormones and lithium-related neuropsychological deficits: A preliminary test of the lithium-thyroid interactive hypothesis. Journal of International Neuropsychological Society, 1, 134.
Prohaska, M. L., Stern, R. al. (1996). The relationship between thyroid status and neuropsychological performance in psychiatric outpatients maintained on lithium. Neuropsychiatry, Neuropsychology & Behavioral Neurology, 9, 30–4.
Quitkin, F. M., Kane, al. (1981). Prophylactic lithium carbonate with and without imipramine for bipolar I patients. Archives of General Psychiatry, 35, 902–7.
Quitkin, F. M., Rabkin, J. al. (1984). Identification of true drug response to antidepressants. Use of pattern analysis. Archives of General Psychiatry, 41(8), 782–6.
Quitkin, F. M., Petkova, al. (2003). When should a trial of fluoxetine for major depression be declared failed?American Journal of Psychiatry, 160, 734–40.
Rabiner, E. A., Gunn, R. al. (2000). Beta-blocker binding to human 5-HT(1A) receptors in vivo and in vitro: implications for antidepressant therapy. Neuropsychopharmacology, 23(3), 285–93.
Rabiner, E. A., Bhagwagar, al. (2001). Pindolol augmentation of selective serotonin reuptake inhibitors: PET evidence that the dose used in clinical trials is too low. American Journal of Psychiatry, 158(12), 2080–2.
Reimherr, F. W., Chouinard, al. (1990). Antidepressant efficacy of sertraline: a double-blind, placebo- and amitriptyline-controlled, multicenter comparison study in outpatients with major depression. Journal of Clinical Psychiatry, 51 (Suppl. B), 18–27.
Rinne, T., deKloet, E. al. (2002). Hyperresponsivenesss of hypothalimic pituitary adrenal axis to combined dexamethasone/corticotropin-releasing hormone challenge in female borderline personality disorder subjects with a history of sustained childhood abuse. Biological Psychiatry, 52, 1102–12.
Rudolph, R. L., Fabre, L. al. (1998). A randomized, placebo-controlled, dose-response trial of venlafaxine hydrochloride in the treatment of major depression. Journal of Clinical Psychiatry, 59(3), 116–22.
Ruhé, H. G., Huyser, J., Swinkels, J. A. & Schene, A. H. (2006). Dose escalation for insufficient response to standard-dose selective serotonin reuptake inhibitors in major depressive disorder: systematic review. British Journal of Psychiatry, 189, 309–16.
Rush, A. J., Batey, S. al. (2001). Does pretreatment anxiety predict response to either bupropion SR or sertraline?Journal of Affective Disorders, 64(1), 81–7.
Rush, A. J., Trivedi, M. H., Wisniewski, S. al. (2006). Bupropion-Sr, Sertraline, or venlafaxine-XR after failure of SSRIs for depression. New England Journal of Medicine, 354(12), 1231–42.
Salzman, C., Wolfson, A. al. (1995). Effect of fluoxetine on anger in symptomatic volunteers with borderline personality disorder. Journal of Clinical Psychopharmacology, 15(1), 23–9.
Schweizer, E., Rickels, al. (1990). What constitutes an adequate antidepressant trial for fluoxetine?Journal of Clinical Psychiatry, 51, 8–11.
Sheehan, D. V., Davidson, al. (1983). Lack of efficacy of a new antidepressant (bupropion) in the treatment of panic disorder with phobias. Journal of Clinical Psychopharmacology, 3(1), 28–31.
Shelton, R. C., Williamson, D. J., Corya, S. al. (2005). Olanzapine/Fluoxetine combination for treatment-resistant depression: a controlled study of SSRI and nortriptyline resistance. Journal of Clinical Psychiatry, 66, 1289–97.
Sokolski, K. N., Conney, J. al. (2004). Once-daily high-dose pindolol for SSRI-refractory depression. Psychiatry Research, 125(2), 81–6.
Soloff, P. H., George, al. (1986). Paradoxical effects of amitriptyline on borderline patients. American Journal of Psychiatry, 143(12), 1603–5.
Solomon, D. A., Ryan, C. al. (1997). A pilot study of lithium carbonate plus divalproex sodium for the continuation and maintenance treatment of patients with bipolar I disorder. Journal of Clinical Psychiatry, 58(3), 95–9.
Solomon, D. A., Keller, M. al. (2000). Multiple recurrences of major depressive disorder. American Journal of Psychiatry, 157(2), 229–33.
Stewart, J. W., Tricamo, al. (1997). Prophylactic efficacy of phenelzine and imipramine in chronic atypical depression: likelihood of recurrence on discontinuation after 6 months' remission. American Journal of Psychiatry, 154(1), 31–6.
Stokes, P. E., Shamoian, C. al. (1971). Efficacy of lithium as acute treatment of manic-depressive illness. Lancet, 1(7713), 1319–25.
Swann, A. C., Bowden, C. al. (1999). Differential effect of number of previous episodes of affective disorder on response to lithium or divalproex in acute mania. American Journal of Psychiatry, 156(8), 1264–6.
Targum, S. D., Greenberg, R. al. (1984). Thyroid hormone and the TRH stimulation test in refractory depression. Journal of Clinical Psychiatry, 45(8), 345–6.
Thase, M. E., Kupfer, D. al. (1989). Treatment of imipramine-resistant recurrent depression: I. An open clinical trial of adjunctive L-triiodothyronine. Journal of Clinical Psychiatry, 50(10), 385–8.
Thoren, P., Asberg, al. (1980). Clomipramine treatment of obsessive-compulsive disorder. I. A controlled clinical trial. Archives of General Psychiatry, 37(11), 1281–5.
Tohen, M., Zhang, al. (2001). Olanzapine versus haloperidol in schizoaffective disorder, bipolar type. Journal of Affective Disorders, 67(1–3), 133–40.
Tohen, M., Vieta, E., Calabrese, al. (2003a). Efficacy of olanzapine and olanzapine–fluoxetine combination in the treatment of Bipolar I depression. Archives of General Psychiatry, 60, 1079–88.
Tohen, M., Zarate, C. A. Jret al. (2003b). The McLean–Harvard First-Episode Mania Study: prediction of recovery and first recurrence. American Journal of Psychiatry, 160(12), 2099–107.
Tollefson, G. D., Rampey, A. H. al. (1994). A multicenter investigation of fixed-dose fluoxetine in the treatment of obsessive-compulsive disorder. Archices of General Psychiatry, 51(7), 559–67.
Trivedi, M. H., Rush, A. J., Wisniewski, S. al. (2006). Evaluation of outcomes with citalopram for depression using measurement-based care in STARD∗D: implications for clinical practice. American Journal of Psychiatry, 163(1), 28–40.
Üstün, T. B., Ayuso-Mateos, J. L., Chatterji, S., Mathers, C. & Murray, C. J. L. (2004). Global burden of depressive disorders in the year 2000. British Journal of Psychiatry, 184, 386–92.
Walsh, B. T., Seidman, S. al. (2002). Placebo response in studies of major depression: variable, substantial, and growing. Journal of the American Medical Association, 287(14), 1840–7.
Wehr, T. A. & Goodwin, F. K. (1979). Rapid cycling in manic depressives induced by tricyclic antidepressants. Archives of General Psychiatry, 36, 555–9.
Wehr, T. A., Sack, D.Rapid cycling affective disorder: Contributing factors and treatment responses in fifty-one patients. American Journal of Psychiatry, 145, 179–84.
Weisler, R. H., Kalali, A. al. (2004). A multicenter, randomized, double-blind, placebo-controlled trial of extended-release carbamazepine capsules as monotherapy for bipolar disorder patients with manic or mixed episodes. Journal of Clinical Psychiatry, 65(4), 478–84.
Weisler, R. H., Keck, P. E., Swann, A. C., Cutler, A. J., Ketter, T. A. & Kalali, A. H. (2005). Extended-release carbamazepine capsules as monotherapy for acute mania in bipolar disorder: a multicenter, randomized, double-blind, placebo-controlled trial. Journal of Clinical Psychiatry, 66, 323–30.
Wong, I. C., Mawer, G. al. (1999). Factors influencing the incidence of lamotrigine-related skin rash. Annales of Pharmacotherapy, 33(10), 1037–42.
Yatham, L. N. (2003). Acute and maintenance treatment of bipolar mania: the role of atypical antipsychotics. Bipolar Disorders, 5 (Suppl. 2), 7–19.
Zajeka, J. M., Weisler, al. (2002). A comparison of the efficacy, safety, and tolerability of divalproex sodium and olanzapine in the treatment of bipolar disorder. Journal of Clinical Psychiatry, 63(12), 1148–55.
Zarate, C. A. J. & Quiroz, J. A. (2003). Combination treatment in bipolar disorder: a review of controlled trials. Bipolar Disorders, 5, 217–25.
Zarate, C. A. J., Payne, J. L.Singh, al. (2004). Pramipexole for bipolar II depression: A placebo-controlled proof of concept study. Biological Psychiatry, 56(1), 54–60.
Zarate, C. A. & Tohen, M. (2004). double-blind comparison of the continued use of antipsychotic treatment versus it's discontinuation in remitted manic patients. American Journal of Psychiatry, 161, 169–71.
Zornberg, G. L. & Pope, H. G. Jr (1993).Treatment of depression in bipolar disorder: new directions for research. Journal of Clinical Psychopharmacology, 13(6), 397–408.