Building Statewide Infrastructure for the Academic Support of Students With Mild Traumatic Brain Injury.

Objectives: To focus attention on building statewide capacity to support students with mild traumatic brain injury (mTBI)/concussion.

Method: Consensus-building process with a multidisciplinary group of clinicians, researchers, policy makers, and state Department of Education personnel.

Results: The white paper presents the group's consensus on the essential components of a statewide educational infrastructure to support the management of students with mTBI.

K-12 students with concussions: a legal perspective.

This article provides a multipart analysis of the public schools' responsibility for students with concussions. The first part provides the prevailing diagnostic definitions of concussions and postconcussive syndrome. The second and central part provides (a) the legal framework of the two overlapping federal laws--the Individuals with Disabilities Education Act and Section 504 of the Rehabilitation Act and the varying state laws or local policies for individual health plans and (b) a summary of the developing body of hearing officer decisions, court decisions, and Office for Civil Rights rulings that have applied this framework to K-12 students with concussions.

Professional development in TBI for educators: the importance of context.

Effective instructional and behavioral support strategies implemented by trained educators can help mitigate the academic and behavioral challenges associated with childhood brain injury. However, the training provided by university teacher preparation programs is clearly inadequate, a problem that cuts across the professions that work with school-aged students. Educators need training in methods validated for students with traumatic brain injury (TBI) and in adapting strategies validated for students with other disabilities.

Quetiapine for insomnia associated with refractory depression exacerbated by phenelzine.

Objective: To report the successful treatment of phenelzine-associated insomnia with low-dose quetiapine in a patient with refractory depression.

Case Summary: A 42-year-old white man with severe major depression unresponsive to selective serotonin-reuptake inhibitors, bupropion, and tricyclic antidepressants improved following treatment with the monoamine oxidase inhibitor (MAOI) phenelzine. Insomnia, present to a moderate degree prior to antidepressant therapy, worsened markedly following phenelzine treatment and failed to respond to diphenhydramine, temazepam, triazolam, clonazepam, zolpidem, or trazodone given at high therapeutic doses.

Once-daily high-dose pindolol for SSRI-refractory depression.

Selective serotonin reuptake inhibitor (SSRI) augmentation with the 5-HT1A antagonist pindolol has met with mixed results. Recent studies using positron emission tomography (PET) suggest that pindolol doses used in these studies were too low to effect 5-HT1A autoreceptor blockade. To test the hypothesis that a single higher dose of pindolol would effectively augment antidepressant responses in SSRI-refractory patients, nine subjects with major depression unresponsive to paroxetine 40 mg/day given for 2 months or more were randomized to AM pindolol 7.