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Clonazepam in the long-term treatment of patients with unipolar depression, bipolar and schizoaffective disorder.
Authors:Dietmar Winkler  Matth?us Willeit  Rainer Wolf  Mara Stamenkovic  Johannes Tauscher  Edda Pjrek  Anastasios Konstantinidis  Shird Schindler  Christian Barnas  Siegfried Kasper
Affiliation:Department of General Psychiatry, University Hospital for Psychiatry, W?hringer Gürtel 18-20, A-1090, Vienna, Austria. dietmar.winkler@akh-wien.ac.at
Abstract: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.
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