[A trial of clonazepam treatment for manic-depressive psychoses]

Clonazepam, which is a benzodiazepine structurally related to chlordiazepoxide hydrochloride, diazepam and nitrazepam, has been available for the treatment of seizure disorders in the USA since 1976 and in Japan since 1981. Recently, clonazepam has attracted interest as drug for the treatment of manic-depressive psychosis. Chouinard et al (1983), Victor et al (1984), Freinhar and Alvarez (1985) and Santos and Morton (1987) have reported on the antimanic properties of clonazepam, and Jones and Chouinard (1985), Zetine and Freedman (1986), Mas et al (1993) and Kishimoto et al(1987) have reported on the antidepressive properties of clonazepam. We have observed the antimanic and antidepressive properties of clonazepam as well. Clonazepam is a useful therapeutic adjunct and the onset of its effect is rapid. We cannot, however, advocate the use of only the therapeutic agent for amelioration of manic-depressive psychosis. Clonazepam is a useful supplement and has a diverse optimum daily dose for acute manic and depressive states. Clonazepam should, at the time, be considered only as an alternative treatment for patients nonresponsive to conventional therapy, and should be used at a dosage of 3-6 mg/day for depressive state and 10 mg/day for acute manic state in combination with other psychotropic drugs.