By J. Walden, H. Grunze
Complement factor: Neuropsychobiology 2002, Vol. forty five, Suppl. 1
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Extra resources for Bipolar Disorders: 2nd Stanley Symposium, Freiburg, November 2000 (Neuropsychobiology)
10 Owen RR Jr, Beake BJ, Marby D, Dessain EC, Cole JO: Response to clozapine in chronic psychotic patients. Psychopharmacol Bull 1989; 25:253–256. 11 Leppig M, Bosch B, Naber D, Hippius H: Clozapine in the treatment of 121 out-patients. Psychopharmacology (Berl) 1989;99(suppl): S77–S79. Neuropsychobiology 2002;45(suppl 1):37–42 12 Naber D, Leppig M, Grohmann R, Hippius H: Efficacy and adverse effects of clozapine in the treatment of schizophrenia and tardive dyskinesia – A retrospective study of 387 patients.
We decided to taper lithium, lamotrigine and paroxetine gradually and to start treatment with clozapine. After the titration phase, the daily dose of clozapine was 250 mg. In the following 6 months, his manias subsided completely, and the depressive episodes became fewer and milder. With the later addition of ˆ-3 fatty acids it was possible to manage also his depressive episodes. The combination treatment of valproate, clozapine and ˆ-3 fatty acids was shown to be safe and effective. The only side effects were weight gain, fatigue and mild diarrhea, which all subsided after some weeks of treatment.
Copyright © 2002 S. Karger AG, Basel ABC © 2002 S. com/journals/nps Dr. Andreas Erfurth Mood Disorders Unit, Department of Psychiatry Münster University Hospital, Albert-Schweitzer-Strasse 11 D–48129 Münster (Germany) Tel. de Table 1. 5 mg; the patient received ECT between days –22 and 1 (9 treatment sessions) Bipolar II½: cyclothymic depression with psychotic features F 37 8 21 1 citalopram 40 mg, perazine 400 mg, diazepam 9 mg Bipolar II½: cyclothymic depression, borderline personality disorder F 21 3 2 3 topiramate 300 mg, fluoxetine 40 mg Bipolar II with rapid cycling, alcohol F abuse when depressed; severe nicotine dependency despite dilatative cardiomyopathy 55 1 20 41 1 mirtazapine 60 mg, sodium valproate 1,250 mg Bipolar II, Binswanger’s disease F 73 1 10 30 6 venlafaxine 375 mg, lithium carbonate 675 mg Bipolar IV with psychotic features M 35 1 1 12 Bipolar IV with psychotic features, benzodiazepine dependency, prostate cancer, Crohn’s disease M 60 3 5 8 Subtype of bipolar disorder according to DSM-IV and to Akiskal and Pinto  Sex Age Number of bipolar episodes including the index episode Bipolar IV with panic attacks, benzodiazepine dependency M 49 1 Bipolar II½: cyclothymic depression with psychotic features, diabetes, hypertension M 49 Bipolar IV with panic attacks, social phobia, agoraphobia, benzodiazepine dependency F Bipolar II with psychotic features, essential tremor Duration of bipolar disorder since first episode years sodium valproate 1,200 mg, haloperidol 2 mg, venlafaxin 350 mg venlafaxine 400 mg, pipamperone 40 mg, bromazepam 9 mg Mean B n–1 weighted standard deviation of MADRS in all patients (last observation carried forward) ECT = Electroconvulsive therapy.