Clonazepam in the long-term treatment of patients with unipolar depression, bipolar and schizoaffective disorder

• Published in: European neuropsychopharmacology 2003-03, Vol.13 (2), p.129-134
• Main Authors: Winkler, Dietmar, Willeit, Matthäus, Wolf, Rainer, Stamenkovic, Mara, Tauscher, Johannes, Pjrek, Edda, Konstantinidis, Anastasios, Schindler, Shird, Barnas, Christian, Kasper, Siegfried
• Format: Article
• Language: English
• Subjects: Adult; Aged; Bipolar disorder; Bipolar Disorder - drug therapy; Bipolar Disorder - psychology; Clonazepam; Clonazepam - therapeutic use; Depression; Depressive Disorder - drug therapy; Depressive Disorder - psychology; Female; Humans; Maintenance treatment; Male; Middle Aged; Mood-stabilizer; Psychotic Disorders - drug therapy; Psychotic Disorders - psychology; Schizoaffective disorder; Statistics, Nonparametric; Time
• ISSN: 0924-977X; 1873-7862
• DOI: 10.1016/S0924-977X(02)00174-8

The value of a long-term treatment with clonazepam in the prophylaxis of affective disorder is discussed controversially in the scientific literature. Altogether there are only a few reports on the use of this compound as a mood stabilizer, most of them describing patients suffering from bipolar affective disorder. The aim of this investigation was to evaluate clonazepam as a phase prophylactic medication in affective disorder. We conducted a retrospective chart review in 34 out-patients of our lithium clinic (15 suffering from unipolar depression, 15 from bipolar disorder, four from schizoaffective disorder), who had been treated with clonazepam as a long-term medication. Clonazepam was either given as monotherapy, or as in the case of lithium non-responders, as adjunctive therapy. Patients with unipolar depression had significantly ( P=0.026) less depressive episodes after initiation of treatment with clonazepam. Patients with bipolar disorder did not benefit from this therapy. Neither manic/hypomanic phases nor depressive episodes were reduced in this group of patients. Interestingly, clonazepam also reduced affective phases in our four schizoaffective patients on a trend level. Our results indicate that patients with unipolar depression may benefit from a maintenance treatment with clonazepam. Due to methodological limitations our results need to be replicated in controlled double-blind randomized clinical trials.