Clozapine treatment of bipolar disorder in a young adolescent

A 13-year-old boy with a 4-year history of bipolar disorder and concomitant obsessive-compulsive disorder required four hospitalizations and two partial hospitalizations due to inadequate responses to combinations of neuroleptics and traditional treatments for bipolar disorder. The use of clozapine in combination with lithium and clomipramine facilitated successful discharge from the hospital and return to a structured school setting. Significant adverse affects from interactions between valproic acid and clozapine necessitated discontinuation of valproic acid.