VOL. 65, NO. 11 NOVEMBER 2004

THE JOURNAL OF CLINICAL PSYCHIATRY

VOLUME 65 NOVEMBER 2004 NUMBER 11

Antidepressants and Suicide Risk in the United States, 1985–1999 THE JOURNAL OF CLINICAL PSYCHIATRY Michael F. Grunebaum, Steven P. Ellis, Shuhua Li, Maria A. Oquendo, and J. John Mann

CME COMMENTARY Metabolic Effects of Treatment With Atypical

CME ARTICLE Impact of Depressive Symptoms Compared With Manic Symptoms in : Results of a U.S. Community-Based Sample

CME ACADEMIC HIGHLIGHTS Utilizing Benzodiazepines in Clinical Practice: An Evidence-Based Discussion

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CELEBRATING 65 YEARS OF SERVICE TO PSYCHIATRISTS

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BOARD OF EDITORS EDITORIAL BOARD The Journal of Clinical Psychiatry (ISSN 0160-6689) is published monthly Editor in Chief ...... Alan J. Gelenberg, M.D. Geoffrey L. Ahern, M.D., Ph.D. by Physicians Postgraduate Press, Inc. Deputy Editor ...... Eric M. Reiman, M.D. Hagop S. Akiskal, M.D. Judith V. Becker, Ph.D. Address correspondence to P.O. Box 752870, Deputy Editor ...... Michael H. Ebert, M.D. Joseph Biederman, M.D. Memphis, TN 38175-2870; phone inquiries to Deputy Editor ..... Marlene P. Freeman, M.D. Jonathan F. Borus, M.D. (901) 751-3800. Rubin Bressler, M.D. Periodical postage paid at Memphis, TN, PUBLICATION STAFF Andrew W. Brotman, M.D. and additional mailing offices. Paula J. Clayton, M.D. Publisher ...... John S. Shelton, Ph.D. POSTMASTER: Send address changes Jonathan O. Cole, M.D. to Circulation Department, Physicians Melissa P. DelBello, M.D. Publisher Emeritus ...... Irving Shelton Postgraduate Press, Inc., P.O. Box 752870, Assistant Publisher ...... Judy Beach William E. Falk, M.D. Maurizio Fava, M.D. Memphis, TN 38175-2870. Publications Manager ...... C. J. Firestone Ellen Frank, Ph.D. Subscriptions for individuals: Permissions Editor ...... Maureen Bunner-Hunsucker Jack M. Gorman, M.D. US: $120.00; Int’l: $160.00 Director of Editorial Services...... Meg M. Waters John H. Greist, M.D. Single issues: US: $20.00; Int’l: $35.00 George T. Grossberg, M.D. Managing Editor ...... Kathryn Hedges The Journal of Clinical Psychiatry is indexed Senior Editor ...... Sarah L. Brownd Bernard I. Grosser, M.D. John G. Gunderson, M.D. in Index Medicus, EMBASE/Excerpta Assistant Editor ...... Sallie L. Gatlin Anne M. Herring, Ph.D. Medica, Psychological Abstracts, Current Assistant Editor ...... Erin Mullin Hanski David B. Herzog, M.D. Contents, Science Citation Index, Hospital Assistant Editor ...... Kathy Shepard Robert M. A. Hirschfeld, M.D. Literature Index, Biological Abstracts, Senior Proofreader ...... Kathy E. Shassere James I. 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Kornstein, M.D. appearing in this publication, including Media Assistant ...... Kyle Baker Richard D. Lane, M.D., Ph.D. editorials, letters, and book reviews, Philip W. Lavori, Ph.D. represent the opinions of the authors and do Media Assistant ...... Janet L. Cunningham R. Bruce Lydiard, M.D., Ph.D. not necessarily reflect the official policy or Director of Circulation ...... Sharon Landers Stephen R. Marder, M.D. opinions of Physicians Postgraduate Press, Circulation Coordinator ...... Dianne Ware Susan L. McElroy, M.D. Herbert Y. Meltzer, M.D. Inc. or the institution with which the author Roger E. Meyer, M.D. is affiliated, unless this is clearly specified. CME INSTITUTE Erwin B. Montgomery, Jr., M.D. Physicians Postgraduate Press, Inc. disclaims Executive Director ...... Jane B. Eckstein Francisco A. Moreno, M.D. any liability to any party for the accuracy, George B. Murray, M.D. Development Director ...... Lee Harrington, R.Ph. completeness, or availability of any and Henry A. 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Rasmussen, M.D. Physicians Postgraduate Press, Inc. so that Project Assistant ...... Elaina Cubine Elliott Richelson, M.D. the author(s) and Physicians Postgraduate Steven P. Roose, M.D. Press, Inc. are protected from misuse of FOUNDING DIRECTORS Patricia I. Rosebush, M.D. copyrighted material. All submissions must Chair: Michael H. Ebert, M.D. John M. Kane, M.D. Jerrold F. Rosenbaum, M.D. be accompanied by a copyright transfer David L. Dunner, M.D. David J. Kupfer, M.D. A. John Rush, Jr., M.D. signed by all authors. Alan J. Gelenberg, M.D. Philip T. Ninan, M.D. José M. Santiago, M.D. Nina R. Schooler, Ph.D. Acceptance of any and all advertising in this CME ADVISORY BOARD Mogens Schou, M.D. publication, or any other material published Chair: John M. Downs, M.D. George M. Simpson, M.D. by Physicians Postgraduate Press, Inc. does Michael H. Ebert, M.D. Alan J. Gelenberg, M.D. Gary W. Small, M.D. not imply endorsement by Physicians Vice Chair: Radwan F. Haykal, M.D. Susan E. Swedo, M.D. Postgraduate Press, Inc. Richard C. Shelton, M.D. Paul King, M.D. John A. Talbott, M.D. Visit our Web site at www.psychiatrist.com. Michael E. Thase, M.D. Benjamin L. Beatus, Jr., M.D. Joseph A. Lieberman, III, M.D. © Copyright 2004 E. Sherwood Brown, Ph.D., M.D. Elizabeth H. B. Lin, M.D. Mauricio F. Tohen, M.D., Dr.P.H. Richard D. Weiner, M.D., Ph.D. Physicians Stephanie Cavanaugh, M.D. Frank W. Ling, M.D. Roger D. Weiss, M.D. Postgraduate Lawrence J. Cohen, Pharm.D. J. Sloan Manning, M.D. Katherine L. Wisner, M.D. Press, Inc. Larry Culpepper, M.D. Meir Steiner, M.D., Ph.D. Carlos A. Zarate, Jr., M.D. All rights reserved.

© COPYRIGHT 2004 PHYSICIANS POSTGRADUATE PRESS, INC. © COPYRIGHT 2004 PHYSICIANS POSTGRADUATE PRESS, INC. THE JOURNAL OF CLINICAL PSYCHIATRY VOLUME 65 NOVEMBER 2004 NUMBER 11

1491 Prevalence of Hyperprolactinemia in CME PRETEST 1444 CME POSTTEST 1582 Schizophrenia: Association With Typical and Atypical Treatment. BRAINSTORMS Julie Montgomery, Elizabeth Winterbottom, Meera Jessani, Eva Kohegyi, Janice Fulmer, Bette Seamonds, and Richard C. Josiassen 1445 Prophylactic Antipsychotics: Do They Keep You From Catching Schizophrenia? 1499 Impact of Depressive Symptoms Compared With Stephen M. Stahl Manic Symptoms in Bipolar Disorder: Results of a U.S. Community-Based Sample. [CME] Joseph R. Calabrese, Robert M. A. Hirschfeld, COMMENTARY Mark A. Frye, and Michael L. Reed

1447 Metabolic Effects of Treatment 1505 Efficacy and Tolerability of Tranylcypromine With Atypical Antipsychotics. [CME] Versus Phenelzine: A Double-Blind Study in John M. Kane, Eugene J. Barrett, Antidepressant-Refractory Depressed Inpatients. Daniel E. Casey, Christoph U. Correll, Tom K. Birkenhäger, Walter W. van den Broek, Alan J. Gelenberg, Samuel Klein, Paul G. Mulder, Jan A. Bruijn, and Peter Moleman and John W. Newcomer 1511 Multiplicity-Adjusted Sample Size Requirements: A Strategy to Maintain Statistical Power With ORIGINAL ARTICLES Bonferroni Adjustments. Andrew C. Leon 1456 Antidepressants and Suicide Risk in the United States, 1985Ð1999. 1515 Topiramate Treatment of Aggression in Michael F. Grunebaum, Steven P. Ellis, Female Borderline Personality Disorder Patients: Shuhua Li, Maria A. Oquendo, and J. John Mann A Double-Blind, Placebo-Controlled Study. Marius K. Nickel, Cerstin Nickel, 1463 Topiramate in the Long-Term Treatment of Ferdinand O. Mitterlehner, Karin Tritt, Binge-Eating Disorder Associated with Obesity. Claas Lahmann, Peter K. Leiberich, Susan L. McElroy, Nathan A. Shapira, Wolfhardt K. Rother, and Thomas H. Loew Lesley M. Arnold, Paul E. Keck, Jr., Norman R. Rosenthal, Shu-Chen Wu, 1520 Combining Stimulants With Julie A. Capece, Lydia Fazzio, and James I. Hudson Monoamine Oxidase Inhibitors: A Review of Uses and One Possible 1470 Adverse Effects of St. John’s Wort: Additional Indication. A Systematic Review. S. Shalom Feinberg Lars Knüppel and Klaus Linde 1480 An Open Trial of Olanzapine in Anorexia Nervosa. 1525 Effects of Changing From Typical to Drugs on Subjective Nicole C. Barbarich, Claire W. McConaha, Jill Gaskill, Maria La Via, Guido K. Frank, Sleep Quality in Patients With Schizophrenia Sarah Achenbach, Katherine H. Plotnicov, in a Japanese Population. and Walter H. Kaye Hidehisa Yamashita, Kazuhiko Mori, Masatsugu Nagao, Yasumasa Okamoto, 1483 Effect of on Cognitive Complaints Shigeru Morinobu, and Shigeto Yamawaki in Patients With . Arifulla Khan, Lawrence D. Ginsberg, 1531 A Retrospective Analysis of Quetiapine in the Gregory M. Asnis, Frederick K. Goodwin, Treatment of Pervasive Developmental Disorders. Kimberly H. Davis, Anupama A. Krishnan, Adam H. Corson, John E. Barkenbus, David J. Posey, and Bryan E. Adams Kimberly A. Stigler, and Christopher J. McDougle

CONTINUED ON NEXT PAGE © COPYRIGHT 2004 PHYSICIANS POSTGRADUATE PRESS, INC. © COPYRIGHT 2004 PHYSICIANS POSTGRADUATE PRESS, INC. THE JOURNAL OF CLINICAL PSYCHIATRY 65:11, NOVEMBER 2004

ORIGINAL ARTICLES LETTERS TO THE EDITOR (continued) 1575 Can Bilateral Prefrontal Repetitive Transcranial 1537 Possible Induction of or Magnetic Stimulation (rTMS) Induce Mania? by Atypical Antipsychotics: A Case Report. An Updated Review of Reported Cases. Armand Hausmann, Karin Kramer-Reinstadler, Fady Rachid, Gilles Bertschy, Guido Bondolfi, Theresia Lechner-Schoner, Michaela Walpoth, and Jean-Michel Aubry Claudia I. Rupp, Hartmann Hinterhuber, and Andreas Conca 1546 Body Mass Index and Future Schizophrenia in Israeli Male Adolescents. 1576 A Case of Venous Thromboembolism Probably Mark Weiser, Hilla Knobler, Gad Lubin, Associated With Hyperprolactinemia After the Daniella Nahon, Efrat Kravitz, Asaf Caspi, Addition of Olanzapine to Typical Antipsychotics. Shlomo Noy, Haim Y. Knobler, and Michael Davidson Shigeru Toki, Shigeru Morinobu, Atsuo Yoshino, and Shigeto Yamawaki

1550 Vitamin B6 Treatment in Acute Neuroleptic-Induced Akathisia: A Randomized, 1577 Prescribing Benzodiazepines for Patients Double-Blind, Placebo-Controlled Study. With Substance Use Disorders. Vladimir Lerner, Joseph Bergman, Daniel Z. Lieberman Nikolay Statsenko, and Chanoch Miodownik ¥ Reply by Robin E. Clark, Haiyi Xie, and Mary F. Brunette 1555 Body-Image Dissatisfaction in Gay Versus Heterosexual Men: Is There Really a Difference? 1578 Anger in Depressive Mixed States. Armand Hausmann, Barbara Mangweth, Franco Benazzi Thomas Walch, Claudia I. Rupp, ¥ Reply by Oommen K. Mammen, Paul A. Pilkonis, and Harrison G. Pope, Jr. Kadiamada N. R. Chengappa, and David J. Kupfer

1559 Treatment of Posttraumatic Stress Disorder With Phenytoin: An Open-Label Pilot Study. BOOK REVIEWS 1580 J. Douglas Bremner, Tanya Mletzko, Silke Welter, Sajid Siddiq, Lai Reed, Chanda Williams, Christine M. Heim, and Charles B. Nemeroff NOW @ Psychiatrist.COM 1585

ACADEMIC HIGHLIGHTS

1565 Utilizing Benzodiazepines in Clinical Practice: INFORMATION FOR AUTHORS An Evidence-Based Discussion. [CME] see www.psychiatrist.com/author.htm for information

© COPYRIGHT 2004 PHYSICIANS POSTGRADUATE PRESS, INC. © COPYRIGHT 2004 PHYSICIANS POSTGRADUATE PRESS, INC. PRETEST AND OBJECTIVES

TM

Articles are selected for CME credit designation on the basis of our assessment of the needs of readers of The Journal of Clinical Psychiatry, with the purpose of providing readers with a curriculum of CME articles on a variety of topics throughout each volume. There are no prerequisites for participating in this activity. To obtain credit, please study the designated articles and complete the Posttest and Registration Form. CME Objectives After studying the Commentary, the article by Calabrese et al., and the ACADEMIC HIGHLIGHTS, you should be able to: ¥ Describe how the recent labeling change for atypical antipsychotic agents will affect your management of patients who need or are already taking these medications. ¥ Assess the functional impact of depressive versus manic symptoms in bipolar disorder. ¥ Summarize the appropriate use of benzodiazepines in anxiety disorders, including long-term efficacy, mechanisms of action, monotherapy or augmentation of psychotherapy, substance abuse, and alternative medications. Accreditation Statement The CME Institute of Physicians Postgraduate Press, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Credit Designation The CME Institute of Physicians Postgraduate Press, Inc. designates this educational activity for up to 2.5 Category 1 credits toward the AMA Physician’s Recognition Award. Each participant should claim only those credits that he/she actually spent in the educational activity. Date of Original Release/Review This educational activity is eligible for CME credit through November 30, 2006. The latest review of this material was October 2004.

This pretest is designed to facilitate your study of the material. 1. Patients taking atypical antipsychotics have a lower risk for diabetes than the general population due to the protective effects of schizophrenia and bipolar disorder. a. True b. False 2. The majority of attempted or completed suicides occur during which phase of bipolar illness? a. Depressive phase b. Manic phase c. Mixed mood episodes d. Periods of euthymia 3. Because many guidelines for the treatment of anxiety disorders recommend selective serotonin reuptake inhibitors as first-line treatments, benzodiazepines have fallen out of favor as anxiety treatments. a. True b. False

Pretest answers and Posttest on page 1582.

1444 J Clin Psychiatry 65:11, November 2004 © COPYRIGHT 2004 PHYSICIANS POSTGRADUATE PRESS, INC. © COPYRIGHT 2004 PHYSICIANS POSTGRADUATE PRESS, INC.