The pharmacological treatment of bipolar disorder: the question of modern advances.

Introduction: Lithium has been the mainstay of treatment for patients with bipolar disorder in the United States since 1970. Major treatment guidelines recommend lithium as a first-line treatment for mania and maintenance treatment of bipolar disorder, yet lithium has fallen out of favor while other agents have grown in popularity. The purpose of this review is to examine the evidence for treatments that were available in 1970 and to determine if the field has made any significant advance in the treatment of mania, bipolar depression, and maintenance.

A randomized, double-blind, and placebo-controlled trial of quetiapine augmentation of fluoxetine in major depressive disorder.

The objective of this study was to investigate whether quetiapine, when compared with placebo, can speed the onset of action and improve the quality of response to fluoxetine treatment in patients suffering from major depressive disorder. A total of 114 patients with major depressive disorder were enrolled in an 8-week treatment study. Patients were initiated on a course of fluoxetine treatment and randomized to quetiapine or placebo.

Coadministration of modafinil and a selective serotonin reuptake inhibitor from the initiation of treatment of major depressive disorder with fatigue and sleepiness: a double-blind, placebo-controlled study.

Background: Previous studies suggest that adjunctive modafinil treatment provides benefit for patients with depression with significant sleepiness and fatigue.

Methods: We conducted a multisite, double-blind, placebo-controlled study of the treatment of major depression characterized by excessive sleepiness and fatigue, adding adjunctive modafinil or placebo to a selective serotonin reuptake inhibitor from the beginning of treatment. Seventy-three of 90 consenting patients met all screening criteria to begin treatment with open-label selective serotonin reuptake inhibitor therapy and double-blind addition of either modafinil (100 mg/d for 1 week then 200 mg/d) or matching placebo for 6 weeks.

General disaster psychiatry.

This article attempts to make further sense of disasters and specifically terrorism as one particular form of disaster from the perspective of psychology and mental health.

Challenges for psychiatry in serving homeless people with psychiatric disorders.

The authors examine current challenges confronting psychiatry in caring for homeless people with psychiatric disorders. After reviewing how psychiatry has historically addressed homelessness and mental illness, the authors discuss the roles that the profession has developed in working with homeless populations. These roles, which encompass clinical, administrative, academic, and advocacy functions, have evolved as a result of trends both in homelessness services and within the profession of psychiatry.