Clonazepam in the long-term treatment of patients with unipolar depression, bipolar and schizoaffective disorder.
The value of a long-term treatment with clonazepam in the prophylaxis of affective disorder is discussed controversially in the scientific literature. Altogether there are only a few reports on the use of this compound as a mood stabilizer, most of them describing patients suffering from bipolar affective disorder. The aim of this investigation was to evaluate clonazepam as a phase prophylactic medication in affective disorder. We conducted a retrospective chart review in 34 out-patients of our lithium clinic (15 suffering from unipolar depression, 15 from bipolar disorder, four from schizoaffective disorder), who had been treated with clonazepam as a long-term medication. Clonazepam was either given as monotherapy, or as in the case of lithium non-responders, as adjunctive therapy. Patients with unipolar depression had significantly (P=0.026) less depressive episodes after initiation of treatment with clonazepam. Patients with bipolar disorder did not benefit from this therapy. Neither manic/hypomanic phases nor depressive episodes were reduced in this group of patients. Interestingly, clonazepam also reduced affective phases in our four schizoaffective patients on a trend level. Our results indicate that patients with unipolar depression may benefit from a maintenance treatment with clonazepam. Due to methodological limitations our results need to be replicated in controlled double-blind randomized clinical trials.
Winkler
Dietmar
D
Department of General Psychiatry, University Hospital for Psychiatry, Währinger Gürtel 18-20, A-1090, Vienna, Austria. dietmar.winkler@akh-wien.ac.at
Willeit
Matthäus
M
Wolf
Rainer
R
Stamenkovic
Mara
M
Tauscher
Johannes
J
Pjrek
Edda
E
Konstantinidis
Anastasios
A
Schindler
Shird
S
Barnas
Christian
C
Kasper
Siegfried
S
D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000523:psychology; D002998:Clonazepam / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000523:psychology; D018709:Statistics, Nonparametric; D013995:Time
D002998:Clonazepam