Guide to Neuropsychiatric Therapeutics Guide to Neuropsychiatric Therapeutics C. Edward Coffey, MD, FANPA Kathleen and Earl Ward Chair of Psychiatry, Vice President, Behavioral Health Services, Henry Ford Health System; Professor of Psychiatry and of Neurology, Wayne State University, Henry Ford Campus, Detroit, Michigan Thomas W. McAllister, MD, FANPA Professor of Psychiatry, Director, Neuropsychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire Jonathan M. Silver, MD, FANPA Clinical Professor of Psychiatry, New York University School of Medicine, New York, New York Acquisitions Editor: Charles W. Mitchell Managing Editor: Lisa Kairis Project Manager: Bridgett Dougherty Associate Director of Marketing: Adam Glazer Design Coordinator: Doug Smock Production Services: Laserwords Private Limited, Chennai, India Printer: R.R. Donnelley, Crawfordsville 2007 by LIPPINCOTT WILLIAMS & WILKINS, a Wolters Kluwer business 530 Walnut Street Philadelphia, PA 19106 USA LWW.com All rights reserved. This book is protected by copyright. No part of this book may be reproduced in any form or by any means, including photocopying, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. Printed in the USA Library of Congress Cataloging-in-Publication Data Guide to neuropsychiatric therapeutics / [edited by] C. Edward Coffey, Thomas W. McAllister, Jonathan Silver. p.;cm. Includes bibliographical references and index. ISBN 13: 978-0-7817-9935-5 ISBN 10: 0-7817-9935-X 1. Neuropsychiatry. 2. Neurobehavioral disorders. I. Coffey, C. Edward, 1952- . II. McAllister, Thomas W. III. Silver, Jonathan M., 1953- . [DNLM: 1. Neurologic Manifestations. 2. Mental Disorders—physio- pathology. 3. Mental Disorders—therapy. 4. Nervous System Diseases —physiopathology. 5. Nervous System Diseases—therapy. 6. Neuro- psychology—methods. WL 340 G946 2007] RC341.G852 2007 616.89—dc22 2006028360 Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication. Application of this information in a particular situation remains the professional responsibility of the practitioner. The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new or infrequently employed drug. Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings. It is the responsibility of the health care provider to ascertain the FDA status of each drug or device planned for use in their clinical practice. To purchase additional copies of this book, call our customer service department at (800) 638-3030 or fax orders to (301) 223-2320. International customers should call (301) 223-2300. Visit Lippincott Williams & Wilkins on the Internet: at LWW.com. Lippincott Williams & Wilkins customer service representatives are available from 8:30 am to 6 pm, EST. 10987654321 To our patients, whose lives we are dedicated to improving through excellence in the science and art of health care and healing Contents Contributors ix Preface xiii 1 Apathy and Related Disorders of Diminished Motivation 1 James D. Duffy 2 Delirium 14 Walter Knysz, III, C. Edward Coffey 3 Cognitive Impairment 24 David B. Arciniegas, Thomas W. McAllister, Daniel I. Kaufer 4 Global Cognitive Impairment: The Dementias 79 Steven A. Rogers, Po H. Lu, Jeffrey L. Cummings 5 Disturbances of Mood, Affect, and Emotion 109 C. Edward Coffey 6 Anxiety 138 Robert G. Robinson, Jess G. Fiedorowicz 7 Psychosis in Neuropsychiatric Disorders 170 Laura A. Flashman, Thomas W. McAllister 8 Nonepileptic Seizures 216 Karen E. Anderson 9 Parkinsonian Movement Disorders 226 Edward C. Lauterbach 10 Hyperkinetic Movement Disorders 243 Edward C. Lauterbach vii viii Contents 11 Changes in Personality 267 John J. Campbell, III 12 Pain 286 Kevin J. Black 13 Sleep Disorders 301 Sheldon Benjamin 14 Unexplained Neuropsychiatric Symptoms 335 Fred Ovsiew, Jonathan M. Silver 15 Intellectual Disabilities of Developmental Onset 348 Alya Reeve 16 Agitation and Aggression 371 Jonathan M. Silver, Stuart C. Yudofsky, Karen E. Anderson 17 Forensic Neuropsychiatry 388 James R. Merikangas 18 Rational Approach to Brain Imaging and Electrophysiology 402 Robin A. Hurley, Nash N. Boutros, Katherine H. Taber Index 429 Contributors Karen E. Anderson, MD Nash N. Boutros, MD Assistant Professor of Psychiatry Professor, Department of Psychiatry and Neurology, Division of Psychiatry and Behavioral Neurosciences and Neurosciences, University and Neurology, Wayne State University, of Maryland Medical Center, School of Medicine, Baltimore, Maryland Detroit, Michigan David B. Arciniegas, MD Director, Neurobehavioral Disorders Program, Associate Professor of Psychiatry C. Edward Coffey, MD and Neurology, University of Colorado Kathleen and Earl Ward Chair School of Medicine, Denver, Colorado; of Psychiatry, Vice President, Behavioral Co-Medical Director, Brain Injury Health Services, Henry Ford Health Rehabilitation Unit, HealthONE Spalding System; Professor of Psychiatry and Rehabilitation Hospital, of Neurology, Wayne State University, Aurora, Colorado Henry Ford Campus, Detroit, Michigan Sheldon Benjamin, MD Professor, Department of Psychiatry and Neurology, University of Massachusetts Medical School; Director of Psychiatric John J. Campbell, MD Education and Training, Director Medical Director of Hospital Psychiatric of Neuropsychiatry, Department Services, Maine Medical Center; Clinical of Psychiatry, UMass Memorial Associate Professor of Psychiatry, Healthcare, Inc., University of Vermont Worcester, Massachusetts College of Medicine, Portland, Maine Kevin J. Black, MD Associate Professor, Department of Psychiatry, Neurology, Radiology, and Neurobiology, Washington University Jeffrey L. Cummings, MD School of Medicine; Attending Professor of Neurology and Psychiatry, Psychiatrist, Department of Psychiatry, Department of Neurology, University Barnes-Jewish Hospital, of California, Los Angeles, St.Louis,Missouri Los Angeles, California ix x Contributors James D. Duffy, MD, FANPA Walter Knysz, III, MD Professor of Psychiatry in Public Health, Director, Consultation-Liaison Psychiatry, Weill Medical College of Cornell Assistant Director, Brain Stimulation University; Director, Institute Service, Department of Behavioral Health, for Palliative Medicine, HenryFordHealthSystem, The Methodist Hospital, Detroit, Michigan Houston, Texas Edward C. Lauterbach, MD, FANPA, Jess G. Fiedorowicz, MD DFAPA Fellow Associate, Department Chief, Division of Adult and Geriatric of Psychiatry, The University of Iowa; Psychiatry, Department of Psychiatry Fellow Associate, Department and Behavioral Sciences, Mercer of Psychiatry, The University of Iowa University School of Medicine; Medical Hospitals and Clinics, Staff, Department of Psychiatry, The Iowa City, Iowa Medical Center of Central Georgia, Macon, Georgia Laura A. Flashman, PhD, ABPP-Cn Associate Professor, Department Po H. Lu, PsyD of Psychiatry, Dartmouth Medical School, Assistant Clinical Professor, Department Dartmouth-Hitchcock Medical Center, of Neurology, University of California Lebanon, New Hampshire; Co-Director, at Los Angeles, Neuropsychology Program, Los Angeles, California Dartmouth-Hitchcock Medical Center and New Hampshire Hospital, Concord, New Hampshire Thomas W. McAllister, MD, FANPA Professor of Psychiatry, Director, Neuropsychiatry Robin A. Hurley, MD, FANPA Dartmouth-Hitchcock Medical Center, Associate Chief of Staff, Mental Health & Lebanon, New Hampshire Behavioral Sciences; Co-Director for Education, Veterans Integrated Service Network 6 Mental Illness Research, JamesR.Merikangas,MD,FACP, Education, and Clinical Center, Salisbury FANPA Veterans Affairs Medical Center, Clinical Professor of Psychiatry Salisbury, North Carolina; Associate and Behavioral Neuroscience, Department Professor, Department of Psychiatry of Psychiatry, George Washington and Radiology, Wake Forest University University, Washington, DC; Attending School of Medicine, Winston-Salem, North in Psychiatry and Neurology, Department Carolina; Clinical Associate Professor, of Psychiatry, Suburban Hospital, Department of Psychiatry, Bethesda, Maryland Baylor College of Medicine, Houston, Texas Fred Ovsiew, MD Professor, Department of Psychiatry, Daniel I. Kaufer, MD University of Chicago; Medical Director, Associate Professor, Director, Memory Adult Inpatient Psychiatry; Chief, Clinical and Cognitive Disorders, Department