Clozapine in the treatment of refractory psychotic mania.

Abstract

OBJECTIVE:

The efficacy of clozapine was examined in a group of patients with treatment-refractory bipolar disorder, manic type with psychotic features.

METHOD:

Twenty-two subjects with treatment-refractory bipolar disorder with active manic and psychotic symptoms participated in a 12-week open-label trial of clozapine. After a 2-10-day drug washout period, patients began treatment with clozapine at 25 mg/day; the dose was increased 25 mg/day (as tolerated) to a maximum level of 550 mg/day. Patients were evaluated longitudinally over the course of the study with the Brief Psychiatric Rating Scale (BPRS), the Young Mania Rating Scale, and the Clinical Global Impressions (CGI) scale.

RESULTS:

Fourteen of the 22 subjects in the study continued taking clozapine for at least 10 of the 12 weeks. Among the entire group, mean improvements of 56. 7%, 56.6%, and 39.1% were seen on the BPRS, Young Mania Rating Scale, and CGI, respectively. Seventeen of the 22 subjects (77.3%) experienced at least a 20% improvement in scores on all three scales.

CONCLUSIONS:

The findings from this open-label study, which are consistent with previous retrospective studies, case reports, and one other open-label prospective study, suggest that clozapine is an effective agent for patients with treatment-refractory psychotic mania.

• Authors: A I Green, M Tohen, J K Patel, M Banov, C DuRand, I Berman, H Chang, C Zarate Jr, J Posener, H Lee, R Dawson, C Richards, J O Cole, A F Schatzberg
• Journal: The American journal of psychiatry (Am J Psychiatry) Vol. 157 Issue 6 Pg. 982-6 (Jun 2000) ISSN: 0002-953X [Print] United States
• PMID: 10831480 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antipsychotic Agents
• Clozapine

Topics

• Adult
• Age Factors
• Antipsychotic Agents (administration & dosage, therapeutic use)
• Bipolar Disorder (drug therapy, psychology)
• Brief Psychiatric Rating Scale (statistics & numerical data)
• Clozapine (administration & dosage, therapeutic use)
• Drug Administration Schedule
• Female
• Humans
• Male
• Patient Dropouts
• Prospective Studies
• Psychiatric Status Rating Scales (statistics & numerical data)
• Regression Analysis
• Sex Factors
• Treatment Outcome