Clozapine for treatment-resistant bipolar disorder: a systematic review

Abstract

The limited current evidence supports the concept that clozapine may be both an effective and a relatively safe medication for TRBD.

Should bipolar disorder treatment be modified depending on staging?

“…In addition, a secondary analysis of data from the functional remediation trial showed that this intervention may also improve verbal memory and functioning in a sample of neurocognitively impaired bipolar patients at 6-month follow-up [22]. Another promising treatment for late-stage bipolar patients is clozapine [23]. A systematic review that included 15 clinical trials showed that clozapine was associated with improvement in social functioning [23].…”

“…Another promising treatment for late-stage bipolar patients is clozapine [23]. A systematic review that included 15 clinical trials showed that clozapine was associated with improvement in social functioning [23]. It is worth mentioning that clozapine may be also effective for treatment-resistant patients with bipolar disorder [23][24][25].…”

“…A systematic review that included 15 clinical trials showed that clozapine was associated with improvement in social functioning [23]. It is worth mentioning that clozapine may be also effective for treatment-resistant patients with bipolar disorder [23][24][25]. Despite proven effectiveness in bipolar disorder, there are concerns regarding some significant side effects, including agranulocytosis, myocarditis, cognitive disturbances, and weight gain.…”

Evidence-Based Pharmacotherapy for Autism Spectrum Disorders

“…Clozapine is a proven therapy for individuals with treatment-resistant bipolar disorder, schizophrenia, and effectively reduces aggression in psychiatrically ill individuals [23][24][25][26]. In ASD, clozapine has been shown to be well tolerated and effective in reducing irritability and aggression in one retrospective chart review and several case reports [27][28][29][30].…”

Switching Bipolar Disorder Patients Treated with Clozapine to Another Antipsychotic Medication: A Mirror Image Study

“…[12][13][14][15][16] The efficacy of clozapine in severe manic patients was reported both as monotherapy and as an add-on strategy. 17 Despite this evidence, clozapine remains underutilized in general 18 and in BD in particular, mostly due to tolerability and safety concerns. 19 The aim of the study was to evaluate the risks and benefits of switching from clozapine to another antipsychotic medication in BD patients with remitted manic, depression, or mixed episodes.…”