Clozapine as add-on medication in the maintenance treatment of bipolar and schizoaffective disorders - A case series

Atypical neuroleptics are increasingly used in the treatment of
bipolar and schizoaffective disorders. Currently, numerous
controlled short-term studies are available for clozapine,
olanzapine, risperidone or quetiapine, but long-term data are still
missing. Three patients (2 with bipolar disorder, 1 with
schizoaffective disorder) are described who showed a marked
reduction of affective symptomatology after clozapine had been
added to mood stabilizer pretreatment. The patients were seen once
a month before and after the introduction of clozapine for at least
6 months. Treatment response was evaluated using different rating
scales (IDS, YMRS; GAF; CGIBP) and the NIMH Life Chart Methodology.
All patients showed a marked improvement after the add-on treatment
with clozapine had been initiated. Clozapine was tolerated well
with only transient and moderate weight gain and fatigue as only
side effects. This case series underlines the safety and efficacy
of clozapine as add-on medication in the treatment of bipolar and
schizoaffective disorders. Copyright (C) 2002 S. Karger AG, Basel.