Response to clozapine of rapid cycling versus non-cycling patients with a history of mania.

Abstract

OBJECTIVE:

Rapid cycling (RC) bipolar disorder (BD) patients often do not respond fully to mood-stabilizers. Atypical antipsychotics including clozapine may be good candidates as an alternative mood-stabilizer for these patients.

METHODS:

Twenty-eight treatment-resistant patients with either Bipolar Disorder Type I (n = 20), or Schizoaffective Disorder Bipolar Type (n = 8) received clozapine add-on therapy. Patients were followed for up to 1 year. Patients were seen monthly and assessed on a number of symptom domains.

RESULTS:

Fifteen of 28 patients met RC criteria. Differences between groups was non-significant for reported age of onset, age at study entry, past history of treatment or hospitalization, or diagnosis. However, significantly more women were RC. More than 80% of patients in either group showed at least some improvement over the 1-year study. Random regression analyses found the non-rapid cycling (NRC) group experienced significantly greater improvement than RC patients (p < 0.0001).

CONCLUSIONS:

Clozapine is more effective in NRC patients with a history of mania in comparison to patients with a recent history of RC.

• Authors: Trisha Suppes, M Erkan Ozcan, Thomas Carmody
• Journal: Bipolar disorders (Bipolar Disord) Vol. 6 Issue 4 Pg. 329-32 (Aug 2004) ISSN: 1398-5647 [Print] Denmark
• PMID: 15225152 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Antipsychotic Agents
• Clozapine

Topics

• Adult
• Antipsychotic Agents (therapeutic use)
• Bipolar Disorder (drug therapy, psychology)
• Clozapine (therapeutic use)
• Diagnostic and Statistical Manual of Mental Disorders
• Female
• Follow-Up Studies
• Humans
• Male
• Severity of Illness Index
• Treatment Outcome