Adjunctive clonazepam for maintenance treatment of bipolar affective disorder. 1990

G S Sachs, and J F Rosenbaum, and L Jones
Clinical Psychopharmacology Unit, Massachusetts General Hospital, Boston 02176.

In light of the reported efficacy of clonazepam in treating acute mania, we conducted a retrospective review of clinical experience with this agent in maintenance treatment of patients with bipolar affective disorder. Twenty patients with bipolar affective disorder treated with adjunctive clonazepam were identified. A case vignette and summary data on all 20 patients are presented. Clonazepam had been prescribed, in a manner similar to neuroleptics, as part of the maintenance regimen and/or on an as needed basis for acute exacerbations. In six of 17 patients previously receiving combined lithium and neuroleptic treatment, clonazepam successfully replaced the neuroleptic. Overall, eight patients were rated much improved or very much improved, including three of the five cases initially rated most severely ill. Possible mechanisms and treatment strategies are discussed.

UI MeSH Term Description Entries
D008094 Lithium An element in the alkali metals family. It has the atomic symbol Li, atomic number 3, and atomic weight [6.938; 6.997]. Salts of lithium are used in treating BIPOLAR DISORDER. Lithium-7,Lithium 7
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011569 Psychiatric Status Rating Scales Standardized procedures utilizing rating scales or interview schedules carried out by health personnel for evaluating the degree of mental illness. Factor Construct Rating Scales (FCRS),Katz Adjustment Scales,Lorr's Inpatient Multidimensional Psychiatric Rating Scale,Wittenborn Scales,Edinburgh Postnatal Depression Scale,Mini International Neuropsychiatric Interview
D002998 Clonazepam An anticonvulsant used for several types of seizures, including myotonic or atonic seizures, photosensitive epilepsy, and absence seizures, although tolerance may develop. It is seldom effective in generalized tonic-clonic or partial seizures. The mechanism of action appears to involve the enhancement of GAMMA-AMINOBUTYRIC ACID receptor responses. 2H-1,4-Benzodiazepin-2-one, 5-(2-chlorophenyl)-1,3-dihydro-7-nitro-,Klonopin,Antelepsin,Rivotril,Ro 5-4023,Ro 54023
D004305 Dose-Response Relationship, Drug The relationship between the dose of an administered drug and the response of the organism to the drug. Dose Response Relationship, Drug,Dose-Response Relationships, Drug,Drug Dose-Response Relationship,Drug Dose-Response Relationships,Relationship, Drug Dose-Response,Relationships, Drug Dose-Response
D004334 Drug Administration Schedule Time schedule for administration of a drug in order to achieve optimum effectiveness and convenience. Administration Schedule, Drug,Administration Schedules, Drug,Drug Administration Schedules,Schedule, Drug Administration,Schedules, Drug Administration
D004359 Drug Therapy, Combination Therapy with two or more separate preparations given for a combined effect. Combination Chemotherapy,Polychemotherapy,Chemotherapy, Combination,Combination Drug Therapy,Drug Polytherapy,Therapy, Combination Drug,Chemotherapies, Combination,Combination Chemotherapies,Combination Drug Therapies,Drug Polytherapies,Drug Therapies, Combination,Polychemotherapies,Polytherapies, Drug,Polytherapy, Drug,Therapies, Combination Drug
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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