» Articles » PMID: 31379632

Clozapine in Treatment-Resistant Bipolar Disorder With Suicidality. Three Case Reports

Overview
Specialty Psychiatry
Date 2019 Aug 6
PMID 31379632
Citations 8
Authors
Affiliations
Soon will be listed here.
Abstract

Bipolar disorder is associated with a high risk of suicide attempts and suicide deaths. The suicide mortality of people with bipolar disorder is approximately 25 times higher than the general population. No approved pharmacological strategies for suicidal thoughts and attempts in bipolar disorder have been introduced so far, and lithium remains as the first-line treatment for suicidal subjects. Clozapine is also a potentially good candidate for this indication. This case series represents three treatment-resistant bipolar patients with severe suicidal ideation who responded to low-dose clozapine treatment.

Citing Articles

Effects of Sex Differences and Combined Use of Clozapine on Initial Dosage Optimization of Valproic Acid in Patients with Bipolar Disorder.

Shen W, Hu K, Shi H, Jiang L, Zhang Y, He S Curr Pharm Des. 2024; 30(29):2290-2302.

PMID: 38984572 DOI: 10.2174/0113816128323367240704095109.


Rethinking Clozapine: Lights and Shadows of a Revolutionary Drug.

DellOsso L, Bonelli C, Nardi B, Giovannoni F, Pronesti C, Cremone I Brain Sci. 2024; 14(1).

PMID: 38275523 PMC: 10813979. DOI: 10.3390/brainsci14010103.


Anti-suicide effect of lithium at infratherapeutic dose, a case report.

Fernandez-Macho J, Reina-Dominguez M Actas Esp Psiquiatr. 2022; 50(5):241-245.

PMID: 36273384 PMC: 10803842.


Therapeutic Interventions to Mitigate Mitochondrial Dysfunction and Oxidative Stress-Induced Damage in Patients with Bipolar Disorder.

Madireddy S, Madireddy S Int J Mol Sci. 2022; 23(3).

PMID: 35163764 PMC: 8836876. DOI: 10.3390/ijms23031844.


Clozapine: Why Is It So Uniquely Effective in the Treatment of a Range of Neuropsychiatric Disorders?.

Gammon D, Cheng C, Volkovinskaia A, Baker G, Dursun S Biomolecules. 2021; 11(7).

PMID: 34356654 PMC: 8301879. DOI: 10.3390/biom11071030.


References
1.
Suppes T, Webb A, Paul B, Carmody T, Kraemer H, Rush A . Clinical outcome in a randomized 1-year trial of clozapine versus treatment as usual for patients with treatment-resistant illness and a history of mania. Am J Psychiatry. 1999; 156(8):1164-9. DOI: 10.1176/ajp.156.8.1164. View

2.
Leveque J, Macias W, Rajadhyaksha A, Carlson R, Barczak A, Kang S . Intracellular modulation of NMDA receptor function by antipsychotic drugs. J Neurosci. 2000; 20(11):4011-20. PMC: 4203343. View

3.
Ciapparelli A, DellOsso L, Pini S, Chiavacci M, Fenzi M, Cassano G . Clozapine for treatment-refractory schizophrenia, schizoaffective disorder, and psychotic bipolar disorder: a 24-month naturalistic study. J Clin Psychiatry. 2000; 61(5):329-34. DOI: 10.4088/jcp.v61n0502. View

4.
Vangala V, Brown E, Suppes T . Clozapine associated with decreased suicidality in bipolar disorder: a case report. Bipolar Disord. 2001; 1(2):123-4. DOI: 10.1034/j.1399-5618.1999.010210.x. View

5.
Meltzer H, Alphs L, Green A, Altamura A, Anand R, Bertoldi A . Clozapine treatment for suicidality in schizophrenia: International Suicide Prevention Trial (InterSePT). Arch Gen Psychiatry. 2003; 60(1):82-91. DOI: 10.1001/archpsyc.60.1.82. View