title: Clonazepam in the long-term treatment of patients with unipolar depression, bipolar and schizoaffective disorder.
abstract: 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.
authors.affiliation: Department of General Psychiatry, University Hospital for Psychiatry, Währinger Gürtel 18-20, A-1090, Vienna, Austria. dietmar.winkler@akh-wien.ac.at
authors.forename: Dietmar
authors.initials: D
authors.lastname: Winkler
authors.forename: Matthäus
authors.initials: M
authors.lastname: Willeit
authors.forename: Rainer
authors.initials: R
authors.lastname: Wolf
authors.forename: Mara
authors.initials: M
authors.lastname: Stamenkovic
authors.forename: Johannes
authors.initials: J
authors.lastname: Tauscher
authors.forename: Edda
authors.initials: E
authors.lastname: Pjrek
authors.forename: Anastasios
authors.initials: A
authors.lastname: Konstantinidis
authors.forename: Shird
authors.initials: S
authors.lastname: Schindler
authors.forename: Christian
authors.initials: C
authors.lastname: Barnas
authors.forename: Siegfried
authors.initials: S
authors.lastname: Kasper
mesh_terms: 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
chemical_list: D002998:Clonazepam