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Pharmacotherapy of Pathological Grief Responses

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Clinical Handbook of Bereavement and Grief Reactions

Part of the book series: Current Clinical Psychiatry ((CCPSY))

Abstract

Complicated Grief (CG) is a loss-specific affective disorder that has been shown to respond to psychotherapy. The evidence for pharmacological treatment of this disorder is more limited, but given the time-intensive nature and limited availability of evidence-based therapy in the community, medications remain an important adjunctive intervention deserving of further study. In addition, the death of a loved one may precipitate or exacerbate one of several psychiatric conditions, including acute stress disorder, posttraumatic stress disorder, and major depressive disorder. This chapter reviews the clinical and neurobiological rationale for a pharmacologic approach to treating CG, and the evidence base for antidepressant agents and other medications in the treatment of this condition. Pharmacological treatments of other loss-related conditions will also be briefly reviewed.

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References

  1. APA. Diagnostic and statistical manual of mental disorders DSM5. 5th ed. Washington DC: American Psychiatric Publishing; 2013.

    Google Scholar 

  2. Shear K, Frank E, Houck PR, Reynolds CF 3rd. Treatment of complicated grief: a randomized controlled trial. JAMA. 2005;293(21):2601–8.

    Article  CAS  PubMed  Google Scholar 

  3. Shear MK, Frank E, Foa E, Cherry C, Reynolds CF III, Vander Bilt J, et al. Traumatic grief treatment: a pilot study. Am J Psychiatry. 2001;158(9):1506–8.

    Article  CAS  PubMed  Google Scholar 

  4. Shear MK, Reynolds CF 3rd, Simon NM, Zisook S, Wang Y, Mauro C, et al. Optimizing treatment of complicated grief: a randomized clinical trial. JAMA Psychiatry. 2016;73(7):685–94.

    Article  PubMed  Google Scholar 

  5. Fontenot MB, Kaplan JR, Manuck SB, Arango V, Mann JJ. Long-term effects of chronic social stress on serotonergic indices in the prefrontal cortex of adult male cynomolgus macaques. Brain Res. 1995;705(1–2):105–8.

    Article  CAS  PubMed  Google Scholar 

  6. Prigerson HG, Shear MK, Jacobs SC, Reynolds CF 3rd, Maciejewski PK, Davidson JR, et al. Consensus criteria for traumatic grief. A preliminary empirical test. Br J Psychiatry. 1999;174:67–73.

    Article  CAS  PubMed  Google Scholar 

  7. Shear MK, Simon N, Wall M, Zisook S, Neimeyer R, Duan N, et al. Complicated grief and related bereavement issues for DSM-5. Depress Anxiety. 2011;28(2):103–17.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Jacobs SC, Nelson JC, Zisook S. Treating depressions of bereavement with antidepressants. A pilot study. Psychiatr Clin North Am. 1987;10(3):501–10.

    CAS  PubMed  Google Scholar 

  9. Pasternak RE, Reynolds CF 3rd, Schlernitzauer M, Hoch CC, Buysse DJ, Houck PR, et al. Acute open-trial nortriptyline therapy of bereavement-related depression in late life. J Clin Psychiatry. 1991;52(7):307–10.

    CAS  PubMed  Google Scholar 

  10. Zisook S, Shuchter SR, Pedrelli P, Sable J, Deaciuc SC. Bupropion sustained release for bereavement: results of an open trial. J Clin Psychiatry. 2001;62(4):227–30.

    Article  CAS  PubMed  Google Scholar 

  11. Reynolds CF 3rd, Miller MD, Pasternak RE, Frank E, Perel JM, Cornes C, et al. Treatment of bereavement-related major depressive episodes in later life: a controlled study of acute and continuation treatment with nortriptyline and interpersonal psychotherapy. Am J Psychiatry. 1999;156(2):202–8.

    PubMed  Google Scholar 

  12. Zygmont M, Prigerson HG, Houck PR, Miller MD, Shear MK, Jacobs S, et al. A post hoc comparison of paroxetine and nortriptyline for symptoms of traumatic grief. J Clin Psychiatry. 1998;59(5):241–5.

    Article  CAS  PubMed  Google Scholar 

  13. Shear MK, Fagiolini A, Houck P, Simon N, Frank E, Reynolds C, et al. Escitalopram for complicated grief: a pilot study. In: NCDEU 46th annual meeting abstracts. Boca Raton, FL: National Institute of Mental Health; 2006.

    Google Scholar 

  14. Simon NM, Thompson EH, Pollack MH, Shear MK. Complicated grief: a case series using escitalopram. Am J Psychiatry. 2007;164(11):1760–1.

    Article  PubMed  Google Scholar 

  15. Hensley PL, Slonimski CK, Uhlenhuth EH, Clayton PJ. Escitalopram: an open-label study of bereavement-related depression and grief. J Affect Disord. 2009;113(1–2):142–9.

    Article  CAS  PubMed  Google Scholar 

  16. Warner J, Metcalfe C, King M. Evaluating the use of benzodiazepines following recent bereavement. Br J Psychiatry. 2001;178(1):36–41.

    Article  CAS  PubMed  Google Scholar 

  17. Davydow DS, Gifford JM, Desai SV, Needham DM, Bienvenu OJ. Posttraumatic stress disorder in general intensive care unit survivors: a systematic review. Gen Hosp Psychiatry. 2008;30(5):421–34.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Gelpin E, Bonne O, Peri T, Brandes D, Shalev AY. Treatment of recent trauma survivors with benzodiazepines: a prospective study. J Clin Psychiatry. 1996;57(9):390–4.

    CAS  PubMed  Google Scholar 

  19. Mellman TA, Bustamante V, David D, Fins AI. Hypnotic medication in the aftermath of trauma. J Clin Psychiatry. 2002;63(12):1183–4.

    Article  PubMed  Google Scholar 

  20. Cook JM, Biyanova T, Marshall R. Medicating grief with benzodiazepines: physician and patient perspectives. Arch Intern Med. 2007;167(18):2006–7.

    Google Scholar 

  21. Simon NM, Shear MK, Fagiolini A, Frank E, Zalta A, Thompson EH, et al. Impact of concurrent naturalistic pharmacotherapy on psychotherapy of complicated grief. Psychiatry Res. 2008;159(1–2):31–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Lee DJ, Schnitzlein CW, Wolf JP, Vythilingam M, Rasmusson AM, Hoge CW. Psychotherapy versus pharmacotherapy for posttraumatic stress disorder: systemic review and meta-analyses to determine first-line treatments. Depress Anxiety. 2016;33(9):792–806.

    Article  CAS  PubMed  Google Scholar 

  23. O'Connor MF, Wellisch DK, Stanton AL, Eisenberger NI, Irwin MR, Lieberman MD. Craving love? Enduring grief activates brain’s reward center. Neuroimage. 2008;42(2):969–72.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Insel TR. Is social attachment an addictive disorder? Physiol Behav. 2003;79(3):351–7.

    Article  CAS  PubMed  Google Scholar 

  25. Hendershot CS, Wardell JD, Samokhvalov AV, Rehm J. Effects of naltrexone on alcohol self-administration and craving: meta-analysis of human laboratory studies. Addict Biol. 2016. https://doi.org/10.1111/adb.12425.

  26. Hamilton JD, Nguyen QX, Gerber RM, Rubio NB. Olanzapine in cocaine dependence: a double-blind, placebo-controlled trial. Am J Addict. 2009;18(1):48–52.

    Article  PubMed  Google Scholar 

  27. Kampman KM, Pettinati HM, Lynch KG, Whittingham T, Macfadden W, Dackis C, et al. A double-blind, placebo-controlled pilot trial of quetiapine for the treatment of Type A and Type B alcoholism. J Clin Psychopharmacol. 2007;27(4):344–51.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. O'Connor MF. Immunological and neuroimaging biomarkers of complicated grief. Dialogues Clin Neurosci. 2012;14(2):141–8.

    PubMed  PubMed Central  Google Scholar 

  29. O'Connor MF, Shear MK, Fox R, Skritskaya N, Campbell B, Ghesquiere A, et al. Catecholamine predictors of complicated grief treatment outcomes. Int J Psychophysiol. 2013;88(3):349–52.

    Article  PubMed  Google Scholar 

  30. Eisenberger NI. The neural basis of social pain: findings and implications. In: MacDonald G, Jensen-Campbell LA, editors. Social pain: neuropsychological and health implications of loss and exclusion. Washington, DC: American Psychological Association; 2010. p. 53–78.

    Google Scholar 

  31. Parkes C. Bereavement: studies of grief in later life. London: Tavistock; 1972.

    Google Scholar 

  32. Robinaugh DJ, LeBlanc NJ, Vuletich HA, McNally RJ. Network analysis of persistent complex bereavement disorder in conjugally bereaved adults. J Abnorm Psychol. 2014;123(3):510–22.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Dewall CN, Macdonald G, Webster GD, Masten CL, Baumeister RF, Powell C, et al. Acetaminophen reduces social pain: behavioral and neural evidence. Psychol Sci. 2010;21(7):931–7.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. University of Michigan, Institute for Healthcare Policy and Innovation, North Campus Research Complex, 2800 Plymouth Road, Building 14, Suite G100, Ann Arbor, MI, 48109, USA

    Mary C. Vance M.D.

  2. Center for Anxiety and Traumatic Stress Disorders and Complicated Grief Program, Massachusetts General Hospital, Boston, MA, USA

    Eric Bui M.D., Ph.D.

  3. Harvard Medical School, Boston, MA, USA

    Eric Bui M.D., Ph.D.

Authors
  1. Mary C. Vance M.D.
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  2. Eric Bui M.D., Ph.D.
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Corresponding author

Correspondence to Mary C. Vance M.D. .

Editor information

Editors and Affiliations

  1. Department of Psychiatry, Massachussetts General Hospital Department of Psychiatry, Boston, Massachusetts, USA

    Eric Bui

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Vance, M.C., Bui, E. (2018). Pharmacotherapy of Pathological Grief Responses. In: Bui, E. (eds) Clinical Handbook of Bereavement and Grief Reactions . Current Clinical Psychiatry. Humana Press, Cham. https://doi.org/10.1007/978-3-319-65241-2_13

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  • DOI: https://doi.org/10.1007/978-3-319-65241-2_13

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  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-65240-5

  • Online ISBN: 978-3-319-65241-2

  • eBook Packages: MedicineMedicine (R0)

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