Clonazepam in Acute Mania: A Double Blind Trial

Abstract

In a double-blind trial involving acutely manic patients, clonazepam was compared to placebo, both groups receiving chlorpromazine as needed. The group receiving clonazepam showed significantly more improvement in their manic but not their psychotic symptoms compared to the placebo group. This effect was not primarily related to the sedative effects of clonazepam. Clonazepam tended to reduce the need for phenothiazine medication. Side effects related to sedation were more common to the clonazepam group. These findings are the first to indicate that clonazepam may have a specific antimanic effect over and above that of phenothiazines alone.

The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders: Update 2009 on the Treatment of Acute Mania

“…Besides effecting the GABA A receptor, clonazepam may also modulate the central serotonergic metabolism (Lima 1991). In a small doubleblind study (Edwards et al 1991), clonazepam was superior to placebo. However, since the duration of the trial was only 5 days and since considerable amounts of chlorpromazine were given in both groups, any true antimanic efficacy can not be inferred.…”

The Pharmacological Treatment of Bipolar Disorder: The Question of Modern Advances

“…78 Overall, the data for clonazepam in mania are robust. 24,91,93,94 Maintenance. Benzodiazepines have not been shown to be effective in reducing manic episodes.…”

Medikamentöse Behandlung akuter Manien

“…Clonazepam und Lorazepam wurden in randomisierten,kontrollierten Studien auf ihre antimanische Wirksamkeit überprüft [7,11,13]. Clonazepam zeigte sich in einer 5-tägigen Studie gegenüber Placebo überlegen [13]. Des Weiteren beschrieben Clark et al [11] in ihrer Studie keine Unterschiede in der Wirksamkeit…”