Journals / Türk Psikiyatri Dergisi / 2019 / Cilt: 30 - Sayı: 4

The Role of Clozapine as a Mood Regulator in the Treatment of Rapid Cycling Bipolar Affective Disorder

Klozapinin Hızlı Döngülü Bipolar Afektif Bozuklukta Duygudurum Düzenleyicisi Olarak Rolü

Pages
268–271
DOI
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AI Summary & Key Takeaways

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⚡ TL;DR(Too Long; Didn't Read)

The results show that clozapine reduces the episode frequency and the duration in rapid cycling Bipolar Affective Disorder which does not respond to all conventional treatments, including lithium, valproic acid, carbamazepine and antipsychotic drugs.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: In this study, we aimed to investigate the effect of the clozapine on the course of the rapid cycling Bipolar Affective Disorder.
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Key Findings & Data:Method: The study group was formed with the patients aged between 18 and 65 years of age, who met the criteria for the diagnosis of Bipolar Affective Disorder according to the Diagnostic and Statistical Manual of Mental Disorders 4th Edition, with rapid cycling characteristics.
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Conclusion & Impact:The results show that clozapine reduces the episode frequency and the duration in rapid cycling Bipolar Affective Disorder which does not respond to all conventional treatments, including lithium, valproic acid, carbamazepine and antipsychotic drugs.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Objective: In this study, we aimed to investigate the effect of the clozapine on the course of the rapid cycling Bipolar Affective Disorder. Method: The study group was formed with the patients aged between 18 and 65 years of age, who met the criteria for the diagnosis of Bipolar Affective Disorder according to the Diagnostic and Statistical Manual of Mental Disorders 4th Edition, with rapid cycling characteristics. Variables like the number of mania and depressive episodes, the days spent in mania and in depression and the number of hospitalization and attempted suicide, in the year before starting clozapine were determined and compared with the annual data after starting the clozapine. Results: Eleven female and two male patients who met the inclusion criteria were included in this study. The group`s average daily use of clozapine was 180 mg (25-600 mg). There was a statistically significant difference in the number of days spent in the depression, the days spent in the mania, the number of depressive episodes and manic episodes, the number of hospitalizations and the suicide attempts after the clozapine use. Conclusion: In this study, it was determined that clozapine was effective as a mood stabilizer in Bipolar Affective Disorder treatment. The results show that clozapine reduces the episode frequency and the duration in rapid cycling Bipolar Affective Disorder which does not respond to all conventional treatments, including lithium, valproic acid, carbamazepine and antipsychotic drugs.

Özet

Amaç: Bu çalışmada hızlı döngülü Bipolar Afektif Bozuklukta (BAB) klozapin kullanımının hastalığın gidişatına etkisinin araştırılması hedeflenmiştir. Yöntem: Çalışma grubu Mental Bozuklukların Tanısal ve Sayımsal El Kitabı 4. Baskı’ya göre BAB tanı ölçütlerini karşılayan, 18-65 yaşları arasında ve hızlı döngülü olan hastalardan oluşmuştur. Hastaların; klozapin başlanmadan önceki bir yıllık süre içerisindeki; mani ve depresif atak sayıları, manide ve depresyonda geçirdikleri günler, hastaneye yatış ve intihar girişiminde bulunma sayıları gibi değişkenleri belirlenmiş ve klozapin başlandıktan sonraki bir yıllık takip verileriyle karşılaştırılmıştır. Bulgular: Dahil edilme ölçütlerini karşılayan 11 kadın ve 2 erkek hasta bu çalışma kapsamına alındı. Grubun ortalama klozapin kullanım dozu 180 mg’dır (25-600 mg). Klozapin kullanımı sonrasında depresyonda geçirilen gün sayısı, manide geçirilen gün sayısı, depresyon atak sayısı, mani atak sayısı, hastanede yatış sayısı ve intihar girişimi sayısında istatiksel olarak anlamlı şekilde değişiklik saptanmıştır. Sonuç: Bu çalışmada klozapinin BAB’da bir duygudurum düzenleyicisi olarak etkili olduğu tespit edilmiştir. Sonuçlar, klozapin tedavisinin atak sıklığını ve süresini lityum, valproik asit, karbamazepin ve antipsikotik ilaçlarla yapılan tedaviler de dahil olmak üzere tüm geleneksel tedavilere yanıt vermeyen hızlı döngülü BAB’da azalttığını göstermektedir.

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Cite This Article

KILINÇEL, O., KILINÇEL, Ş., GÜNDÜZ, C., CANGÜR, Ş., AKKAYA, C. (2019). The Role of Clozapine as a Mood Regulator in the Treatment of Rapid Cycling Bipolar Affective Disorder. Türk Psikiyatri Dergisi, Cilt: 30 - Sayı: 4, 268–271. https://ajindex.com/articles/78774

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References (17)

  1. Akdeniz F (1997)
  2. Hızlı Döngülü Bozukluk, Ege Psikiyatri Sürekli Yayınları, Kitap 3 s:8-15.
  3. Akkaya C, Altın M, Kora K ve ark. (2012) Türkiye’de bipolar I bozukluğu hastalarının, sosyodemografik ve klinik özellikleri-HOME çalışması. Klinik Psiko farmakoloji Bülteni 22:31-42.
  4. Amerikan Psikiyatri Birliği (2000) Ruhsal Bozuklukların Tanısal ve Sayımsal El Kitabı, Dördüncü Baskı Yeniden Gözden Geçirilmiş Tam Metin (DSMIV-R), Amerikan Psikiyatri Birliği, Köroğlu E (çeviri editörü), Hekimler Yayın Birliği 2007.
  5. Banov MD, Zarate CA, Scialabba D ve ark. (1993) Clozapine therapy in refractory affective disorders. Presented at the annual meeting of the American College of Neuropsychopharmocology Dec 14, 1993;
  6. Honolulu, Hawaii. Bauer MS, Calabrese JR, Dunner DL ve ark. (1994) Multisite data reanalysis of the validity of rapid cycling as a course modifier for bipolar disorder in DSM-IV. Am J Psychiatry 151: 506–15.
  7. Bauer M, Beaulieu S, Dunner DL ve ark. (2008) Rapid cycling bipolar disorder diagnostic concepts. Bipolar Disord 10: 153–62.
  8. Calabrese JR, Meltzer HY, Markovitz PJ (1991) Clozapine prophylaxis in rapid cycling bipolar disorder. J Clin Psychopharmacol:396-7.
  9. Calabrese JR, Kimmel SE, Woyshville MJ ve ark. (1996) Clozapine for treatment refractory mania. Am J Psychiatry153:759–64.
  10. Calabrese JR, Shelton MD, Rapport DJ ve ark. (2001) Current research on rapid cycling bipolar disorder and its treatment. J Affect Disord 67:241– 55. Carvalho A, Mcintyre R (2015) Treatment-Resistant Mood Disorders Oxford Psychiatry Library 23-45.
  11. Dunner DL, Fieve RR (1974) Clinical factors in lithium carbonate prophylaxis failure. Arch Gen Psychiatry 30: 229–33.
  12. Frye MA, Ketter TA, Altshuler LL ve ark. (1998) Clozapine in bipolar disorder: treatment implications for other atypical antipsychotics. J Affect Disord 48:91–04.
  13. Garno JL (2005) Impact of childhood abuse on the clinical course of bipolar disorder. Br J Psychiatry 186:121-5.
  14. Kesebir S, Vahip S, Akdeniz F ve ark. (2005) Bipolar Bozuklukta Mizaç ile Klinik Özelliklerin İlişkisi, Türk Psikiyatri Dergisi 16: 164-9.
  15. Kupka RW, Luckenbaugh DA, Post RM ve ark (2005) Comparison of rapidcycling and non-rapid-cycling bipolar disorder based on prospective mood ratings in 539 out patients. Am J Psychiatry 162: 1273–80.
  16. McElroy SL, Dessain EC, Pope HG ve ark. (1991) Clozapine in the treatment of psychotic mood disorders, schizoaffective disorder, and schizophrenia. J Clin Psychiatry 52:411-4.
  17. Post RM, Kramlinger KG, Altshuler LL ve ark. (1