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References
- ↑ Tatsumi M, Groshan K, Blakely RD, Richelson E (11 December 1997). "Pharmacological profile of antidepressants and related compounds at human monoamine transporters". European Journal of Pharmacology. 340 (2–3): 249–58. doi:10.1016/s0014-2999(97)01393-9. PMID 9537821.
- ↑ Fedder D, Patel H, Saadabadi A (2021). "Atomoxetine". PMID 29630286.
{{cite journal}}: Cite journal requires|journal=(help) - ↑ Dell'Osso B, Palazzo MC, Oldani L, Altamura AC (December 2011). "The noradrenergic action in antidepressant treatments: pharmacological and clinical aspects". CNS Neurosci Ther. 17 (6): 723–32. doi:10.1111/j.1755-5949.2010.00217.x. PMC 6493872 . PMID 21155988.
- ↑ Fleurence R, Williamson R, Jing Y, Kim E, Tran QV, Pikalov AS, Thase ME (2009). "A systematic review of augmentation strategies for patients with major depressive disorder". Psychopharmacol Bull. 42 (3): 57–90. PMID 19752841.
- 1 2 Corp SA, Gitlin MJ, Altshuler LL (September 2014). "A review of the use of stimulants and stimulant alternatives in treating bipolar depression and major depressive disorder". J Clin Psychiatry. 75 (9): 1010–8. doi:10.4088/JCP.13r08851. PMID 25295426.
- ↑ Arias HR, Santamaría A, Ali SF (2009). "Pharmacological and neurotoxicological actions mediated by bupropion and diethylpropion". Int. Rev. Neurobiol. International Review of Neurobiology. 88: 223–55. doi:10.1016/S0074-7742(09)88009-4. ISBN 9780123745040. PMID 19897080.
- ↑ Dale E, Bang-Andersen B, Sánchez C (2015). "Emerging mechanisms and treatments for depression beyond SSRIs and SNRIs". Biochem. Pharmacol. 95 (2): 81–97. doi: 10.1016/j.bcp.2015.03.011 . PMID 25813654.
- ↑ Challman TD, Lipsky JJ (2000). "Methylphenidate: its pharmacology and uses". Mayo Clin. Proc. 75 (7): 711–21. doi: 10.4065/75.7.711 . PMID 10907387.
- ↑ Prommer E (2012). "Methylphenidate: established and expanding roles in symptom management". Am J Hosp Palliat Care. 29 (6): 483–90. doi:10.1177/1049909111427029. PMID 22144657. S2CID 21384037.
- ↑ Urban AE, Cubała WJ (February 2020). "The role of eugeroics in the treatment of affective disorders". Psychiatr Pol. 54 (1): 21–33. doi: 10.12740/PP/OnlineFirst/90687 . PMID 32447354.
- ↑ Kleeblatt J, Betzler F, Kilarski LL, Bschor T, Köhler S (May 2017). "Efficacy of off-label augmentation in unipolar depression: A systematic review of the evidence". Eur Neuropsychopharmacol. 27 (5): 423–441. doi:10.1016/j.euroneuro.2017.03.003. PMID 28318897. S2CID 3740987.
- ↑ Nunez NA, Singh B, Romo-Nava F, Joseph B, Veldic M, Cuellar-Barboza A, Cabello Arreola A, Vande Voort JL, Croarkin P, Moore KM, Biernacka J, McElroy SL, Frye MA (March 2020). "Efficacy and tolerability of adjunctive modafinil/armodafinil in bipolar depression: A meta-analysis of randomized controlled trials". Bipolar Disord. 22 (2): 109–120. doi: 10.1111/bdi.12859 . PMID 31643130.
- ↑ Szmulewicz AG, Angriman F, Samamé C, Ferraris A, Vigo D, Strejilevich SA (June 2017). "Dopaminergic agents in the treatment of bipolar depression: a systematic review and meta-analysis". Acta Psychiatr Scand. 135 (6): 527–538. doi:10.1111/acps.12712. PMID 28256707. S2CID 3712257.
- ↑ "SPRAVATO™ (esketamine) nasal spray FDA label" (PDF). Food and Drug Administration. 5 March 2019. Retrieved 6 March 2019.
- ↑ Zhang MW, Harris KM, Ho RC (2016). "Is off-label repeat prescription of ketamine as a rapid antidepressant safe? Controversies, ethical concerns, and legal implications". BMC Med Ethics. 17: 4. doi: 10.1186/s12910-016-0087-3 . PMC 4714497 . PMID 26768892.
- ↑ Thase ME (2016). "Adverse Effects of Second-Generation Antipsychotics as Adjuncts to Antidepressants: Are the Risks Worth the Benefits?". Psychiatr. Clin. North Am. 39 (3): 477–86. doi:10.1016/j.psc.2016.04.008. PMID 27514300.