Clozapine in the treatment of dysphoric mania

Suppes, Trisha; McElroy, Susan L.; Gilbert, Jeffrey M.; Dessain, Eric C.; Cole, Jonathan O.

doi:10.1016/0006-3223(92)90108-c

Cited by 116 publications

(37 citation statements)

References 18 publications

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“…Recent trials in severly manic patients, e.g., a randomized, controlled trial with risperidone , and post hoc subgroup analyses of severly manic patients in randomized, controlled trials with other atypical antipsychotics support the usefulness of risperidone, ziprasidone, aripiprazole and olanzapine in this patient group. Clozapine has also shown efficacy in refractory mania, both euphoric and dysphoric, in open prospective trials (CE ''C1'') (Mü ller and Heipertz 1977; Suppes et al 1992;Antonacci and Swartz 1995;Calabrese et al 1996;Green et al 2000). Finally, the efficacy of electroconvulsive therapy in severe and delirious manic states is supported by numerous case series (CE ''C1'') (Grunze and Scharfetter 2004).…”

Section: Severity Of Maniamentioning

confidence: 96%

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

Grunze

Vieta

Goodwin

et al. 2009

The World Journal of Biological Psychiatry

318

247

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These updated guidelines are based on a first edition that was published in 2003, and have been edited and updated with the available scientific evidence until end of 2008. Their purpose is to supply a systematic overview of all scientific evidence pertaining to the treatment of acute mania in adults. The data used for these guidelines have been extracted from a MEDLINE and EMBASE search, from the clinical trial database clinicaltrials.gov, from recent proceedings of key conferences, and from various national and international treatment guidelines. Their scientific rigor was categorised into six levels of evidence (AÁF). As these guidelines are intended for clinical use, the scientific evidence was finally asigned different grades of recommendation to ensure practicability.

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Section: Severity Of Maniamentioning

confidence: 96%

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

Grunze

Vieta

Goodwin

et al. 2009

The World Journal of Biological Psychiatry

318

247

View full text Add to dashboard Cite

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“…There are number of retrospective reviews (30)(31)(32)(33) and prospective open-label studies with small numbers of patients that suggest that clozapine may have antimanic effects (32,33). Prospective open-label trials also suggest that clozapine may be effective in patients with dysphonic mania (34) and in those who do not respond to lithium or valproate (35,36). There is also a double-blind comparison study against chlorpromazine that suggested a faster onset of action for clozapine (23).…”

Section: Clozapinementioning

confidence: 99%

Antipsychotic agents in the treatment of bipolar mania

Tohen

Vieta

2009

Bipolar Disorders

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Objectives: Antipsychotics have been widely used in the treatment of bipolar mania. The purpose of this manuscript was to briefly review the evidence of typical and atypical antipsychotics for the treatment of bipolar mania.Methods: A detailed literature review was conducted on the use of typical and atypical antipsychotics in the treatment of bipolar mania using standard search engines. A summary of the published literature on each agent is described followed by a discussion on the overall comparison of the different agents.Results: For typical antipsychotics, up until recently, there was a paucity of published evidence on their strengths and limitations in the treatment of bipolar mania. Recent studies have demonstrated clear evidence on the efficacy of haloperidol on the treatment of acute mania. The literature suggests a faster onset of action of haloperidol as compared to either lithium or atypical antipsychotics. A limitation of typical antipsychotics however, is the risk of tardive dyskinesia, extrapyramidal side effects and a possible increased risk of non‐adherence. Evidence on the efficacy for atypical antipsychotics has been demonstrated for aripiprazole, clozapine, olanzapine, quetiapine, risperidone and ziprasidone. Limitations as regards the use of atypical antipsychotics include the risk of weight gain and dyslipidemia. Comparison among different atypical antipsychotics agents are difficult to determine as there are no conclusive head to head studies. There is also a paucity of studies comparing atypical antipsychotics with lithium.Conclusions: Evidence exists on the efficacy of both typical and atypical antipsychotics on the treatment of acute mania such that they are now clearly first‐line along with lithium. An important limitation of the published literature is that most of the studies were designed to obtain regulatory approval for the different agents therefore the generalizability of the findings to clinical practice remains unclear.

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“…64 Quetiapine and Aripiprazol were not specifically studied for MS, although there are good results in the treatment of pure mania. [69][70][71][72] Clozapine: Suppes et al 73 report improvement in the symptomatology in one study on 6 patients with MS.…”

Section: T T T T Treatment Reatment Reatment Reatment Reatmentmentioning

confidence: 99%