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Clozapine in treatment-refractory mood disorders
S E Kimmel1, J R Calabrese, M J Woyshville
1Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, Ohio.
The Journal of Clinical Psychiatry
|September 1, 1994
Summary
Clozapine shows promise for treating manic episodes in patients resistant to standard treatments like lithium. This atypical antipsychotic offers a potential new option for difficult-to-treat bipolar and schizoaffective disorders.
Area of Science:
- Psychiatry
- Pharmacology
Background:
- Lithium is a primary treatment for bipolar disorder, but many patients do not respond.
- Atypical antipsychotics, such as clozapine, are increasingly being investigated for mood disorder efficacy.
Purpose of the Study:
- To review existing data on clozapine for mood disorders.
- To present preliminary findings on clozapine's use in acute mania for treatment-refractory patients.
Main Methods:
- A 13-week open prospective trial of clozapine was conducted.
- Twenty-five patients with DSM-III-R criteria for manic bipolar or schizoaffective disorder were included.
- Patients had failed or were intolerant to lithium, anticonvulsants, and typical neuroleptics.
Main Results:
- Eighteen out of 25 patients (72%) showed over a 50% reduction in Young Mania Rating Scale scores.
- Clozapine demonstrated efficacy in treating acute mania in this treatment-resistant group.
Conclusions:
- Clozapine may be effective for acute mania in patients resistant to conventional treatments.
- The efficacy of clozapine extends beyond schizophrenia to treatment-resistant mood disorders.