Response to clozapine of rapid cycling versus non-cycling patients with a history of mania.
OBJECTIVE
Rapid cycling (RC) bipolar disorder (BD) patients often do not respond fully to mood-stabilizers. Atypical antipsychotics including clozapine may be good candidates as an alternative mood-stabilizer for these patients.


METHODS
Twenty-eight treatment-resistant patients with either Bipolar Disorder Type I (n = 20), or Schizoaffective Disorder Bipolar Type (n = 8) received clozapine add-on therapy. Patients were followed for up to 1 year. Patients were seen monthly and assessed on a number of symptom domains.


RESULTS
Fifteen of 28 patients met RC criteria. Differences between groups was non-significant for reported age of onset, age at study entry, past history of treatment or hospitalization, or diagnosis. However, significantly more women were RC. More than 80% of patients in either group showed at least some improvement over the 1-year study. Random regression analyses found the non-rapid cycling (NRC) group experienced significantly greater improvement than RC patients (p < 0.0001).


CONCLUSIONS
Clozapine is more effective in NRC patients with a history of mania in comparison to patients with a recent history of RC.
Suppes
Trisha
T
Department of Psychiatry, Bipolar Disorder Clinic and Research Program, The University of Texas Southwestern Medical Center, Dallas, TX 75390-9121, USA. trisha.suppes@utsouthwestern.edu
Ozcan
M Erkan
ME
Carmody
Thomas
T
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000523:psychology*; D003024:Clozapine / Q000627:therapeutic use*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012720:Severity of Illness Index; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D003024:Clozapine