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

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.