Clozapine for treatment-refractory mania

Joseph R. Calabrese*, Susan E. Kimmel, Mark J. Woyshville, Daniel J. Rapport, Carl J. Faust, Paul A. Thompson, Herbert Y. Meltzer

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

263 Scopus citations


Objective: The efficacy of clozapine for treatment-resistant mania was examined in a prospective trial for patients with bipolar or schizoaffective disorder. Method: The subjects were 25 acutely manic patients with either bipolar disorder (N=10) or schizoaffective disorder-bipolar subtype (N=15) for whom lithium, anticonvulsants, and neuroleptics had been ineffective, had produced intolerable side effects, or both. After a 7-day washout, the patients were treated with clozapine monotherapy. They were evaluated over 13 weeks with the Young Mania Rating Scale and the Brief Psychiatric Rating Scale (BPRS). Results: Of thee 25 patients, 18 (72%) exhibited marked improvement on the Young Mania Rating Scale, and eight (32%) exhibited marked improvement on the BPRS. The bipolar patients as compared to schizoaffective patients, and the nonrapid as compared to rapid cyclers, had significantly greater improvement in total BPRS score. Conclusions: These results suggest that clozapine is an effective therapy for treatment-resistant bipolar and schizoaffective mania.

Original languageEnglish (US)
Pages (from-to)759-764
Number of pages6
JournalAmerican Journal of Psychiatry
Issue number6
StatePublished - Jan 1 1996

ASJC Scopus subject areas

  • Psychiatry and Mental health


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