Clozapine for treatment-refractory mania
1996; American Psychiatric Association; Volume: 153; Issue: 6 Linguagem: Inglês
10.1176/ajp.153.6.759
ISSN1535-7228
AutoresJoseph R. Calabrese, Susan E. Kimmel, M J Woyshville, Daniel Rapport, Carl J. Faust, Patricia A. Thompson, Herbert Y. Meltzer,
Tópico(s)Electroconvulsive Therapy Studies
ResumoBack to table of contents Previous article Next article No AccessClozapine for treatment-refractory maniaPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.153.6.759AboutSectionsView articleAbstractPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail View articleAbstractOBJECTIVE: 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 schizo- affective 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. Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - American Journal of Psychiatry $35.00 Add to cart PPV Articles - American Journal of Psychiatry Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? 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FiguresReferencesCited byDetailsCited byA systematic review of clozapine's effectiveness for primary psychotic and bipolar disorders in older adults22 February 2021 | International Psychogeriatrics, Vol. 34, No. 10Psychiatric symptoms and mortality in older adults with major psychiatric disorders: results from a multicenter study20 June 2022 | European Archives of Psychiatry and Clinical Neuroscience, Vol. 28Mood Stabilizers: Course and Duration of Therapy, Withdrawal Syndromes, and Resistance to Therapy5 November 2022Psychopharmacological Recovery-Oriented Treatments in Bipolar Disorders1 July 2022Clozapina en pacientes con trastorno esquizoafectivo: una revisión sistemáticaRevista de Psiquiatría y Salud Mental, Vol. 14, No. 3Clozapine in patients with schizoaffective disorder: A systematic reviewRevista de Psiquiatría y Salud Mental (English Edition), Vol. 14, No. 3Clozapine for Treatment-Refractory Aggressive Behavior12 September 2020 | Psychiatric Quarterly, Vol. 92, No. 2How to treat mania3 August 2020 | Acta Psychiatrica Scandinavica, Vol. 10Clozapine in bipolar disorder: A systematic review and meta-analysisJournal of Psychiatric Research, Vol. 125The CINP Guidelines on the Definition and Evidence-Based Interventions for Treatment-Resistant Bipolar Disorder5 December 2019 | International Journal of Neuropsychopharmacology, Vol. 23, No. 4Clozapine and the Course of Bipolar Disorder in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD): La clozapine et l'évolution du trouble bipolaire dans le Programme d'amélioration systématique du traitement du trouble bipolaire (STEP-BD)21 January 2020 | The Canadian Journal of Psychiatry, Vol. 65, No. 4Mood Stabilizers: Course and Duration of Therapy, Withdrawal Syndromes, and Resistance to Therapy17 December 2019Frontiers in Psychiatry, Vol. 10Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder14 March 2018 | Bipolar Disorders, Vol. 20, No. 2Asian Journal of Psychiatry, Vol. 36Clinical Practice & Epidemiology in Mental Health, Vol. 14, No. 1Effect of clozapine on rates of risk incidents and functioning in female adolescents with a diagnosis of severe emerging emotionally unstable personality disorder4 May 2017 | The Journal of Forensic Psychiatry & Psychology, Vol. 28, No. 6Mayo Clinic Proceedings, Vol. 92, No. 10Case Reports in Psychiatry, Vol. 2016Bipolar Disorders, Vol. 17, No. 4Bipolar Disorders, Vol. 17, No. 3The Psychopharmacology Algorithm Project at the Harvard South Shore ProgramHarvard Review of Psychiatry, Vol. 22, No. 5Ziprasidone as Adjunctive Therapy in Severe Bipolar Patients Treated with ClozapineISRN Psychiatry, Vol. 2014CNS Spectrums, Vol. 19, No. 5Chronic clozapine reduces rat brain arachidonic acid metabolism by reducing plasma arachidonic acid availability6 December 2012 | Journal of Neurochemistry, Vol. 124, No. 3Journal of the Chinese Medical Association, Vol. 76, No. 10Bipolar Disorders, Vol. 15, No. 4Refractoriness in Bipolar Disorder: Definitions and Evidence‐Based Treatment2 August 2011 | CNS Neuroscience & Therapeutics, Vol. 18, No. 3Psychopharmacology, Vol. 222, No. 4Bipolar Disorders, Vol. 14, No. 8Bipolar Disorders, Vol. 14, No. 6Safety and efficacy of olanzapine monotherapy in treatment-resistant bipolar mania: a 12-week open-label study15 November 2011 | Human Psychopharmacology: Clinical and Experimental, Vol. 26, No. 8A 19-Year-Old Male with Mood Instability and Psychotic SymptomsPsychiatric Annals, Vol. 41, No. 6Clinical Utility of Clozapine in Bipolar Disorder13 April 2011Journal of Neurochemistry, Vol. 119, No. 2Expert Review of Neurotherapeutics, Vol. 11, No. 1The long-term effectiveness of clozapine and lamotrigine in a patient with treatment-resistant rapid-cycling bipolar disorder8 February 2010 | Journal of Psychopharmacology, Vol. 24, No. 12Acute Mania13 August 2010The inpatient with maniaActa Psychiatrica Scandinavica, Vol. 121, No. 1Bipolar disorder8 March 2013Clozapine Monotherapy for 66 Months in Treatment Resistant Bipolar DisorderJournal of Clinical Psychopharmacology, Vol. 29, No. 5EMC - Psychiatrie, Vol. 6, No. 1Irish Journal of Psychological Medicine, Vol. 26, No. 2The World Journal of Biological Psychiatry, Vol. 10, No. 2Bipolar Disorders, Vol. 11Acute and long-term treatment of mania1 April 2022 | Dialogues in Clinical Neuroscience, Vol. 10, No. 2The International Journal of Neuropsychopharmacology, Vol. 11, No. 07Psychopharmacology, Vol. 191, No. 1The International Journal of Neuropsychopharmacology, Vol. 10, No. 05Una revisión sistemática de la eficacia y la seguridad de los antipsicóticos de segunda generación en el tratamiento de la manía12 May 2020 | European psychiatry (Ed. Española), Vol. 13, No. 5Concurrent Abuse of Cannabis Is Associated with a Shorter Duration of Hospitalization in Treatment-Resistant Psychotic Bipolar Inpatients Treated with ClozapineAddictive Disorders & Their Treatment, Vol. 5, No. 1Emerging Treatments for Bipolar Disorder: Safety and Adverse Effect Profiles4 December 2016 | Annals of Pharmacotherapy, Vol. 40, No. 2Current Psychiatry Reports, Vol. 8, No. 6A systematic review of the efficacy and safety of second generation antipsychotics in the treatment of mania16 April 2020 | European Psychiatry, Vol. 21, No. 1Bipolar Disorders, Vol. 8, No. 2Combination Treatment of Clozapine and Topiramate in Resistant Rapid-Cycling Bipolar DisorderClinical Neuropharmacology, Vol. 28, No. 3Human Psychopharmacology: Clinical and Experimental, Vol. 20, No. 1European Archives of Psychiatry and Clinical Neuroscience, Vol. 255, No. 1Psychiatrie und Psychotherapie, Vol. 1, No. 2Biological Psychiatry, Vol. 57, No. 9Brain Research, Vol. 1049, No. 2Toward Convergence in the Medication Treatment of Bipolar Disorder and SchizophreniaHarvard Review of Psychiatry, Vol. 13, No. 1The Journal of ECT, Vol. 21, No. 1Bipolar Disorders, Vol. 7Bipolar Disorders, Vol. 7, No. 4Pediatric Drugs, Vol. 7, No. 5Australian and New Zealand Clinical Practice Guidelines for the Treatment of Bipolar Disorder26 June 2016 | Australian & New Zealand Journal of Psychiatry, Vol. 38, No. 5Psychopharmacology, Vol. 176, No. 2European Archives of Psychiatry and Clinical Neurosciences, Vol. 254, No. 5L'Encéphale, Vol. 30, No. 5Journal of Psychiatric Research, Vol. 38, No. 1Psychiatric Clinics of North America, Vol. 27, No. 1Neuroscience Letters, Vol. 368, No. 3Bipolar Disorders, Vol. 6, No. 4Australian and New Zealand Journal of Psychiatry, Vol. 38, No. 5Acta Psychiatrica Scandinavica, Vol. 109, No. 6Acute ManiaPsychiatric Annals, Vol. 33, No. 12Tratamiento psicofarmacológico de la manía12 May 2020 | European psychiatry (Ed. Española), Vol. 10, No. 7Alternatives to lithium and divalproex in the maintenance treatment of bipolar disorder28 May 2003 | Bipolar Disorders, Vol. 5, No. 3Differential Effect of Quetiapine on Depressive Symptoms in Patients with Partially Responsive Schizophrenia2 July 2016 | Journal of Psychopharmacology, Vol. 17, No. 2Neurobiologia do transtorno de humor bipolar e tomada de decisão na abordagem psicofarmacológicaRevista de Psiquiatria do Rio Grande do Sul, Vol. 25, No. suppl 1Psychopharmacology, Vol. 166, No. 4European Journal of Pharmacology, Vol. 461, No. 2-3Journal of Affective Disorders, Vol. 73, No. 1-2Olanzapine in the acute treatment of bipolar I disorder with a history of rapid cyclingJournal of Affective Disorders, Vol. 73, No. 1-2CNS Spectrums, Vol. 8, No. 12Current Opinion in Psychiatry, Vol. 16, No. 1Perspectives In Psychiatric Care, Vol. 39, No. 3The World Journal of Biological Psychiatry, Vol. 4, No. 1Clozapine: Treatment of Mood SymptomsPsychiatric Annals, Vol. 32, No. 12Impact of Clozapine versus Haloperidol on Conditional Release Time and Rates of Revocation in a Forensic Psychiatric Population4 December 2017 | Journal of Pharmacy Technology, Vol. 18, No. 4The comorbidity of bipolar and anxiety disorders: prevalence, psychobiology, and treatment issuesJournal of Affective Disorders, Vol. 68, No. 1The Expanding Pharmacopoeia for Bipolar DisorderAnnual Review of Medicine, Vol. 53, No. 1American Journal of Medical Genetics, Vol. 114, No. 4International Journal of Geriatric Psychiatry, Vol. 17, No. 9Human Psychopharmacology: Clinical and Experimental, Vol. 17, No. 8Current Psychiatry Reports, Vol. 4, No. 1European Journal of Pharmacology, Vol. 443, No. 1-3Progress in Neuro-Psychopharmacology and Biological Psychiatry, Vol. 26, No. 3What makes a drug a primary mood stabilizer?18 March 2002 | Molecular Psychiatry, Vol. 7, No. S1Journal of Child and Adolescent Psychopharmacology, Vol. 12, No. 2Current Opinion in Psychiatry, Vol. 15Expert Review of Neurotherapeutics, Vol. 2, No. 1Expert Review of Neurotherapeutics, Vol. 2, No. 3Revista Brasileira de Psiquiatria, Vol. 24, No. 1American Journal of Medical Genetics, Vol. 105, No. 3Drug Development Research, Vol. 54, No. 2Biological Psychiatry, Vol. 50, No. 11Journal of Affective Disorders, Vol. 65, No. 1Journal of Affective Disorders, Vol. 67, No. 1-3Psychiatry Research, Vol. 104, No. 3Journal of Clinical Psychopharmacology, Vol. 21, No. 2International Clinical Psychopharmacology, Vol. 16, No. 2Expert Opinion on Pharmacotherapy, Vol. 2, No. 12Expert Opinion on Pharmacotherapy, Vol. 2, No. 4Bulletin of the Menninger Clinic, Vol. 65, No. 1CNS Drugs, Vol. 15, No. 9Pharmacotherapy of Affective DisordersOnset of action of antipsychotics in the treatment of mania4 November 2002 | Bipolar Disorders, Vol. 2, No. 3p2Lamotrigine and Clozapine for Bipolar DisorderJOSEPH R. CALABRESE, M.D., and PRASHANT GAJWANI, M.D., 1 September 2000 | American Journal of Psychiatry, Vol. 157, No. 9Pharmacologic agents for the treatment of acute bipolar maniaBiological Psychiatry, Vol. 48, No. 6Atypical antipsychotic drugs in nonschizophrenic psychiatric disordersCurrent Psychiatry Reports, Vol. 2, No. 4Clozapine in the Treatment of Refractory Psychotic ManiaAlan I. Green, M.D., Maricio Tohen, M.D., Dr.P.H., Jayendra K. Patel, M.D., Michael Banov, M.D., Curtiss DuRand, M.D., Ileana Berman, M.D., Howard Chang, M.D., M.P.H., Carlos ZarateJr., M.D., Joel Posener, M.D., Hang Lee, Ph.D., Ree Dawson, Ph.D., Carol Richards, A.M., Jonathan O. Cole, M.D., and Alan F. Schatzberg, M.D.23 January 2015 | American Journal of Psychiatry, Vol. 157, No. 6Psychotropic drug prescription patterns among patients with bipolar I disorder24 December 2001 | Bipolar Disorders, Vol. 2, No. 2Letters to the Editor1 May 2000 | The Canadian Journal of Psychiatry, Vol. 45, No. 4Current Psychiatry Reports, Vol. 2, No. 4Journal of Affective Disorders, Vol. 59Journal of Affective Disorders, Vol. 59Acta Neuropsychiatrica, Vol. 12, No. 3The Journal of ECT, Vol. 16, No. 2Journal of Psychiatric Practice, Vol. 6, No. 6CNS Drugs, Vol. 13, No. 6CNS Drugs, Vol. 14, No. 2The biology of bipolar disorderLetters to the Editor1 November 1999 | The Canadian Journal of Psychiatry, Vol. 44, No. 9Clinical Outcome in a Randomized 1-Year Trial of Clozapine Versus Treatment as Usual for Patients With Treatment-Resistant Illness and a History of ManiaTrisha Suppes, M.D., Ph.D., Andrew Webb, B.A., Betty Paul, L.V.N., Thomas Carmody, Ph.D., Helena Kraemer, Ph.D., and A. John Rush, M.D.1 August 1999 | American Journal of Psychiatry, Vol. 156, No. 8Olanzapine Versus Placebo in the Treatment of Acute ManiaMauricio Tohen, M.D., Dr.P.H., Todd M. Sanger, Ph.D., Susan L. McElroy, M.D., Gary D. Tollefson, M.D., Ph.D., K.N. Roy Chengappa, M.D., David G. Daniel, M.D., Frederick Petty, M.D., Ph.D., Franca Centorrino, M.D., Richard Wang, M.D., Ph.D., Starr L. Grundy, B.Sc.Pharm., Michael G. Greaney, M.S., Thomas G. Jacobs, M.A.S., Stacy R. David, Ph.D., Verna Toma, B.S., and The Olanzapine HGEH Study Group1 May 1999 | American Journal of Psychiatry, Vol. 156, No. 5Toward a rational pharmacotherapy of comorbid substance abuse in schizophrenic patientsSchizophrenia Research, Vol. 35A Review of Bipolar Disorder Among AdultsDonald M. Hilty, M.D., Kathleen T. Brady, M.D., Ph.D., and Robert E. Hales, M.D., M.B.A.1 February 1999 | Psychiatric Services, Vol. 50, No. 2Mental Retardation and Developmental Disabilities Research Reviews, Vol. 5, No. 4Biological Psychiatry, Vol. 45, No. 8Comprehensive Psychiatry, Vol. 40, No. 4European Journal of Pharmacology, Vol. 380, No. 1Journal of Affective Disorders, Vol. 53, No. 3Psychiatry Research, Vol. 87, No. 1Psychiatry Research, Vol. 89, No. 2Psychiatric Clinics of North America, Vol. 22, No. 3Psychiatric Clinics of North America, Vol. 22, No. 4Journal of Clinical Psychopharmacology, Vol. 19, No. 4Pharmacotherapy, Vol. 19, No. 7Pharmacologic Approaches for TreatmentResistant ManiaPsychiatric Annals, Vol. 28, No. 11Clozapine in bipolar disorder: treatment implications for other atypical antipsychoticsJournal of Affective Disorders, Vol. 48, No. 2-3Mood Stabilizer Combinations: A Review of Safety and EfficacyMarlene P. Freeman, M.D., and Andrew L. Stoll, M.D.1 January 1998 | American Journal of Psychiatry, Vol. 155, No. 1European Journal of Pharmacology, Vol. 351, No. 2Pediatric Clinics of North America, Vol. 45, No. 5Journal of Affective Disorders, Vol. 49, No. 2Behandlingsresistent skizofreni10 August 2017 | Nordic Journal of Psychiatry, Vol. 51, No. sup40Nordic Journal of Psychiatry, Vol. 51, No. sup40Current Opinion in Psychiatry, Vol. 11, No. 1Journal of Clinical Psychopharmacology, Vol. 18, No. 1Acta Psychiatrica Scandinavica, Vol. 97, No. 6The New Antipsychotics and Their Therapeutic PotentialPsychiatric Annals, Vol. 27, No. 5The Journal of Clinical Pharmacology, Vol. 37, No. 5Clozapine as a treatment tool: only in resistant schizophrenic patients?16 April 2020 | European Psychiatry, Vol. 12, No. S5 Volume 153Issue 6 June 1996Pages 759-764 Metrics PDF download History Published online 1 April 2006 Published in print 1 June 1996
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