Trisha Suppes1, M Erkan Ozcan, Thomas Carmody. 1. Department of Psychiatry, Bipolar Disorder Clinic and Research Program, The University of Texas Southwestern Medical Center, Dallas, TX 75390-9121, USA. trisha.suppes@utsouthwestern.edu
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.
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: Konstantinos N Fountoulakis; Lakshmi N Yatham; Heinz Grunze; Eduard Vieta; Allan H Young; Pierre Blier; Mauricio Tohen; Siegfried Kasper; Hans Jurgen Moeller Journal: Int J Neuropsychopharmacol Date: 2020-04-23 Impact factor: 5.176
Authors: D J Muzina; C Momah; J M Eudicone; A Pikalov; R D McQuade; R N Marcus; R Sanchez; B X Carlson Journal: Int J Clin Pract Date: 2008-03-25 Impact factor: 2.503