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

doi:10.4324/9781315054308-26

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

Psychiatry and Behavioral Sciences

Research output: Chapter in Book/Report/Conference proceeding › Chapter

Abstract

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 the 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. (Am J Psychiatry 1996; 153:759-764).

Original language	English (US)
Title of host publication	Bipolar Disorder
Subtitle of host publication	The Science of Mental Health
Publisher	Taylor and Francis
Pages	251-256
Number of pages	6
ISBN (Electronic)	9781135712181
ISBN (Print)	9780815337447
DOIs	https://doi.org/10.4324/9781315054308-26
State	Published - Jan 1 2019

ASJC Scopus subject areas

General Psychology

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title = "Clozapine for treatment-refractory mania",

abstract = "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 the 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. (Am J Psychiatry 1996; 153:759-764).",

author = "Calabrese, {Joseph R.} and Kimmel, {Susan E.} and Woyshville, {Mark J.} and Rapport, {Daniel J.} and Faust, {Carl J.} and Thompson, {Paul A.} and Meltzer, {Herbert Y.}",

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AU - Calabrese, Joseph R.

AU - Kimmel, Susan E.

AU - Woyshville, Mark J.

AU - Rapport, Daniel J.

AU - Faust, Carl J.

AU - Thompson, Paul A.

AU - Meltzer, Herbert Y.

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N2 - 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 the 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. (Am J Psychiatry 1996; 153:759-764).

AB - 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 the 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. (Am J Psychiatry 1996; 153:759-764).

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Clozapine for treatment-refractory mania

Abstract

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